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Objective To explore the influencing factors affecting somatosensory evoked potential (SEP) during decompression laminectomy and to establish a prediction model. b>Methods The SEP monitoring data from 120 patients with spinal stenosis who underwent decompression laminectomy at the Spinal Orthopedics Department of Ma'anshan People's Hospital from January 2021 to January 2023 were analyzed retrospectively. Patients were divided into SEP-altered group (n=21) and control group (n=99) based on the presence or absence of SEP signal alteration. Predictors were determined using Lasso regression, cross-validation, logistic regression analysis. A column-line plot predicting change in SEP based on independent predictors was drawn. Receiver operating characteristic (ROC) curves, calibration curves, and clinical decision curves were used to evaluate the model. Results Logistic regression analysis indicated that overweight, hemorrhage, body temperature, and use of electrosurgical equipment were independent risk factors affecting SEP, with statistically significant differences (P＜0.05). In the validation of the model, the AUC of the column-line plot was 0.914, indicating that the model had good discrimination. The optimal calibration curve showed good agreement between predicted and actual values. The clinical decision curve attested to the practical efficacy of the model. Conclusion Factors affecting changes in SEP include overweight, hemorrhage, body temperature, and the use of electrosurgical equipment. The construction of a column chart to forecast SEP changes empowers spinal physicians to implement proactive therapeutic interventions effectively, concurrently enhancing the precision of electrophysiological monitoring.

Background: Cerebrovascular accidents (CVA) was increasing per year. In Indonesia reached 550.000 cases per year. Ten to fifteen percent are types of CVA bleeding (CVA-B). Death and disability as complications of CVA-B are more often compared to an ischemic type. Early diagnosis of CVA-B is key to decreasing it’s complications. Unfortunately, diagnosis of early CVA-B requires excellent effort and spending more expense when using an advanced CT scan. Previous research has shown a relationship between leucocyte count and CVA, but there is no adequate data relating leukocyte count and mean arterial pressure (MAP) with bleeding volume in CVA-B patients. Objective: This study aimed to answer whether Leukocyte count combined with MAP can be a choice to diagnose CVA-B at an early stage. Methods: Analytic observational research was conducted with a cross-sectional approach. The population of this study was all patients with CVA intracerebral bleeding at Ulin Hospital of Banjarmasin. The patient's medical records and CT scans were used to assess the bleeding volume. The number of leukocytes and the patient's mean arterial pressure were tabulated and analyzed to their relationship with bleeding volume. Results: In this study, there was a significant relationship between the number of leukocytes and the volume of intracerebral hemorrhage (r=0.801, p=0.000). There was no significant relationship between the MAP and the volume of intracerebral hemorrhage (r=0,17, p=0,361) Conclusion: There is a strong relationship with a significant relationship between the number of leukocytes and the volume of bleeding in patients with intracerebral hemorrhage but no relationship with MAP.

AIM: To investigate the efficacy of valve removal technology in improved endoscopic dacryocystorhinostomy.METHODS: Prospective randomized controlled study. A total of 92 patients(98 eyes)with nasolacrimal duct obstruction who underwent endoscopic dacryocystorhinostomy in our hospital from November 2020 to September 2022 were selected as the study subjects and they were randomly divided into group A(traditional group)and group B(improved group). The nasal mucosal flap was preserved after incision of the nasal mucosa in group A, the lacrimal sac flap and nasal mucosal flap were trimmed to an appropriate shape after the incision of the lacrimal sac, and the lacrimal sac flap the nasal mucosal flap were matched up. Group B made a “□” shaped incision on the nasal mucosa to remove the complete square nasal mucosa tissue. After the lacrimal sac was incised, the lacrimal sac mucosa was preserved as much as possible, and then the residual nasal mucosa was trimmed to make the lacrimal sac flap close to but not in contact with the residual nasal mucosa. Furthermore, the intraoperative bleeding volume and surgical duration of two groups of patients were recorded, and follow up until 3 mo postoperative. Nasal endoscopy and lacrimal duct flushing examinations were performed at 1 and 3 mo postoperative, respectively. The proliferation of granulation tissue within 5 mm of the ostial postoperative and the therapeutic effect were observed.RESULTS: At 3 mo postoperatively, 6 patients(7 eyes)who were lost to follow-up were excluded. A total of 44 eyes were included in group A, and 47 eyes were included in group B. The bleeding volume [27.00(22.00, 41.00)mL] and the surgical duration [35.00(33.00, 42.00)min] in group B were significantly lower than those in the group A(P

Abstract Background The current concept of bronchoscopy-associated massive airway hemorrhage is not accurate enough, and the amount of bleeding as the only evaluation criterion cannot comprehensively evaluate magnitude of the effects and the severity. Objective To propose the concept of bronchoscopy-associated acute massive airway hemorrhage, analyze its impact on patients and highlight the treatment approach of acute massive airway hemorrhage without ECMO support. Designs A retrospective cohort study. Setting Include all patients who received bronchoscopy intervention therapy at Interventional Pulmonology Center of Emergency General Hospital from 2004 to December 2021. Patients 223 patients met the inclusion criteria. Intervention Patients were divided into two groups: acute massive airway hemorrhage group (n = 29) and non-acute massive airway hemorrhage group (n = 194). Main outcome measures Perioperative adverse events between two groups were the main outcome. Secondary outcome was the impact of lung isolation on patient in group Acute. Results The incidence of acute massive airway hemorrhage was 0.11%, and the incidence of non-acute massive airway hemorrhage was 0.76% in this study. There were significant differences in the incidence of intraoperative hypoxemia, lowest SpO2, hemorrhagic shock, cardiopulmonary resuscitation, intraoperative mortality, and transfer to ICU between acute group and non-acute group (P

Background: The current concept of bronchoscopy-associated massive airway hemorrhage is not accurate enough, and the amount of bleeding as the only evaluation criterion cannot comprehensively evaluate magnitude of the effects and the severity. Objective: To propose the concept of bronchoscopy-associated acute massive airway hemorrhage, analyze its impact on patients and highlight the treatment approach of acute massive airway hemorrhage without ECMO support. Designs: A retrospective cohort study. Setting: Include all patients who received bronchoscopy intervention therapy at Interventional Pulmonology Center of Emergency General Hospital from 2004 to December 2021. Patients: 223 patients met the inclusion criteria. Intervention: Patients were divided into two groups: acute massive airway hemorrhage group (n = 29) and non-acute massive airway hemorrhage group (n = 194). Main outcome measures: Perioperative adverse events between two groups were the main outcome. Secondary outcome was the impact of lung isolation on patient in group Acute. Results: The incidence of acute massive airway hemorrhage was 0.11%, and the incidence of non-acute massive airway hemorrhage was 0.76% in this study. There were significant differences in the incidence of intraoperative hypoxemia, lowest SpO2, hemorrhagic shock, cardiopulmonary resuscitation, intraoperative mortality, and transfer to ICU between acute group and non-acute group (P<0.05, respectively). Lung isolation was used in 12 patients with acute massive airway hemorrhage, and only 2 patients died during the operation. Conclusion: Bronchoscopy-associated acute massive airway hemorrhage had more serious impact on patients due to rapid bleeding, blurred vision of bronchoscopy, inability to stop bleeding quickly, blood filling alveoli, and serious impact on oxygenation of the lung lobes. Polyvinyl chloride single-lumen endotracheal intubation for lung isolation, with its characteristics of low difficulty, wide applicability and available in most hospitals, may reduce the intraoperative mortality of patients with bronchoscopy-associated acute massive airway hemorrhage. Trial registration: Chinese Clinical Trial Registry on 13/03/2022. Registration number: ChiCTR2200057470. Key Points: Bronchoscopy-associated acute massive airway hemorrhage was considered more accurate and meaningful to assess the magnitude of the effects and the severity according to the bleeding volume, bleeding rate, and impact on pulmonary oxygenation function. It was defined as massive hemorrhage of more than 100 ml caused by bronchoscopy, rapid outflow of blood from the bleeding point, blurred vision of bronchoscopy, inability to stop bleeding quickly, and blood filling the alveoli, which seriously affects the oxygen supply function of the lung lobes. Compared with non-acute massive airway hemorrhage, acute massive airway hemorrhage had significant differences in blood loss volume, duration and difficulty of therapy, hemostatic methods and perioperative complications, which brings different effects to patients. Once acute massive airway hemorrhage occurs, it was an emergency, and an effective, feasible and adaptable hemostatic measure was needed to meet the dual functions of ventilation and hemostasis, so as to win valuable time and opportunity for follow-up treatment. Polyvinyl chloride single-lumen endotracheal intubation for lung isolation, with its characteristics of low difficulty, wide applicability and available in most hospitals, may reduce the intraoperative mortality of patients with bronchoscopy-associated acute massive airway hemorrhage. [ABSTRACT FROM AUTHOR]

To investigate the effect of hemocoagulase on coagulation parameters, blood transfusion volume and bleeding volume in patients with severe traumatic fractures. A total of 116 patients with severe traumatic fractures admitted to our hospital. These patients were randomly divided into the study group (hemocoagulase injection) and control group (normal saline injection), with 58 patients in each group. The bleeding time, coagulation time, perioperative bleeding volume, blood transfusion volume, hematology and coagulation parameters of the two groups were observed and compared. At 24 h postsurgery, the bleeding time and coagulation time were significantly shorter in the study group than in the control group (p < 0.05). The intraoperative bleeding volume, 24 h postoperative drainage volume, and blood transfusion volume were significantly lower in the study group than in the control group (p<0.05). In addition, the 24 h postoperative levels of hematology parameters were significantly higher in the study group than in the control group (p < 0.05). However, coagulation parameters were similar in both groups before and at 24 h after surgery. Hemocoagulase has a better hemostatic effect and can effectively reduce perioperative bleeding without affecting the coagulation functions of patients with severe traumatic fractures. Therefore, hemocoagulase is a reliable treatment regimen in clinical practice. [ABSTRACT FROM AUTHOR]

AbstractTo evaluate the effect of hysteroscopy and suture on uterine scar diverticulum (CSD) after caesarean section and its influence on blood loss, operation time and antibiotic time. Eighty-nine patients with CSD were divided into observation group (n = 41 cases) and control group (n = 48 cases). Control group received laparoscopic scar diverticulum resection and suture, while the observation group received hysteroscopic resection of scar diverticulum. The operation time of the observation group was longer, while the bleeding volume and antibiotic administration time were significantly lower. The surgical treatment efficiency of the observation group (97.56%) was significantly higher. After treatment, the observation group’s diverticulum repair indexes (width, depth and lower uterine muscular layer thickness) were better than those of the control group (p

Background: Heavy menstrual bleeding (HMB) is associated with impaired quality of life and may signal serious health problems. Unresolved challenges in measuring menstrual bleeding and identifying HMB have hampered research and clinical care. Self-reported bleeding histories are commonly used but these may be influenced by recall bias, personal beliefs regarding "normal" flow volume, and the experience of other physical symptoms or disruptions to daily life. The potential usefulness of menstrual-tracking mobile applications, which allow real-time user-entered data recording, for assessing HMB has not been studied. We evaluated recall bias in reported period duration, the relationship of tracked period duration and daily flow volume to subsequently reported period heaviness, variation in quality of life associated with increasing period heaviness, and the advantages and limitations of using app-tracked data for clinical and research purposes. Methods: An online questionnaire was distributed to current users of Clue, a commercially available menstrual health tracking app, asking them to characterize their last period. We compared responses to the user's corresponding Clue app-tracked data. The study sample comprised 6546 U.S.-based users (aged 18–45 years). Results: Increasing reported heaviness was associated with increasing app-tracked period length and days of heavy flow, impaired quality-of-life (especially body pain severity), and disrupted activities. Of those reporting having had a heavy/very heavy period, ~ 18% had not tracked any heavy flow, but their period length and quality-of-life indicators were similar to those who had tracked heavy flow. Sexual/romantic activities were the most affected across all flow volumes. Compared to app-tracked data, 44% recalled their exact period length; 83% recalled within ± 1 day. Overestimation was more common than underestimation. However, those with longer app-tracked periods were more likely to underestimate period length by ≥ 2 days, a pattern which could contribute to under-diagnosis of HMB. Conclusion: Period heaviness is a complex construct that encapsulates flow volume and, for many, several other bleeding-associated experiences (period length, bodily impairments, disruptions of daily activities). Even very precise flow volume assessments cannot capture the multi-faceted nature of HMB as experienced by the individual. Real-time app-tracking facilitates quick daily recording of several aspects of bleeding-associated experiences. This more reliable and detailed characterization of bleeding patterns and experiences can potentially increase understanding of menstrual bleeding variability and, if needed, help to guide treatment. [ABSTRACT FROM AUTHOR]

ObjectiveTo construct and verify the risk prediction model for intraoperative hypothermia in patients received radical surgery for gastrointestinal cancer. Methods A total of 276 patients receiving radical gastrointestinal cancer surgery in the Affiliated Hospital of Qingdao University from November 2020 to June 2021 were selected by a convenient sampling as the model group. From July to September 2021, 138 patients undergoing radical surgery were served as validation group. The influencing factors of hypothermia were analyzed based on the data in model group, and the model was constructed using logistic regression， which was respectively verified by Hosmer-Lemeshow and AUC (area under the receiver operating characteristic curve) for the goodness of fit and prediction of the model. R software was used to establish the line column diagram of validation set for external validation. ResultsThe incidence rate of intraoperative hypothermia in model group was 47.1%. Age, BMI, operation time, bleeding volume, volume of colloid, surgical site and insulation method were ultimately included in the prediction model, and sensitivity, specificity and actual accuracy of the model were 0.754, 0.760 and 75.72%, respectively. In validation group, AUC was 0.820, and the accuracy rate was 74.64%. Conclusion In the patients undergoing radical gastrointestinal cancer surgery, the constructed model can effectively predict the risk of intraoperative hypothermia and provide a reference for the clinical screening of patients with high risk of hypothermia during operation.

Hemostatic disturbances after cardiac surgery can lead to excessive postoperative bleeding. Thromboelastography (TEG) was employed to evaluate perioperative coagulative alterations in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB), investigating the correlation between factors concomitant with cardiac surgery and modifications in coagulation. Coagulation index as determined by TEG correlated significantly with postoperative bleeding at 24-72 h after cardiac surgery (P<.001). Among patients with a normal preoperative coagulation index, those with postoperative hypocoagulability showed significantly lower nadir temperature (P = .003), larger infused fluid volume (P = .003), and longer CPB duration (P = .033) than those with normal coagulation index. Multivariate logistic regression showed that nadir intraoperative temperature was an independent predictor of postoperative hypocoagulability (adjusted OR: 0.772, 95% CI: 0.624-0.954, P = .017). Multivariate linear regression demonstrated linear associations of nadir intraoperative temperature (P = .017) and infused fluid volume (P = .005) with change in coagulation index as a result of cardiac surgery. Patients are susceptible to hypocoagulability after cardiac surgery, which can lead to increased postoperative bleeding. Ensuring appropriate temperature and fluid volume during cardiac surgery involving CPB may reduce risk of postoperative hypocoagulability and bleeding. [ABSTRACT FROM AUTHOR]

To evaluate the effect of hysteroscopy and suture on uterine scar diverticulum (CSD) after caesarean section and its influence on blood loss, operation time and antibiotic time. Eighty-nine patients with CSD were divided into observation group (n = 41 cases) and control group (n = 48 cases). Control group received laparoscopic scar diverticulum resection and suture, while the observation group received hysteroscopic resection of scar diverticulum. The operation time of the observation group was longer, while the bleeding volume and antibiotic administration time were significantly lower. The surgical treatment efficiency of the observation group (97.56%) was significantly higher. After treatment, the observation group's diverticulum repair indexes (width, depth and lower uterine muscular layer thickness) were better than those of the control group (p<.05). Hysteroscopic resection of scar diverticulum in CSD reduces intraoperative blood loss and the risk of complications, shortens time of antibiotic administration, and promotes diverticulum repair. What is already known on this subject? Uterine scar diverticulum (CSD) after caesarean section, also called postoperative uterine incision defect (PCSD), is due to poor healing of the uterine incision after caesarean section. What do the results of this study add? Hysteroscopic resection of scar diverticulum in CSD has a significant clinical effect, which can effectively reduce intraoperative blood loss and the risk of complications, shorten the time of antibiotic administration, and promote diverticulum repair. What are the implications of these findings for clinical practice and/or further research? Clinical effect of hysteroscopic resection of scar diverticulum in CSD is significant. [ABSTRACT FROM AUTHOR]

BACKGROUND: Absorbable hemostatic materials are currently a hot field of hemostatic materials. The clinical demand for safe and effective absorbable hemostatic materials is increasing. Fish scale collagen is not only safe and effective, but also can turn fish scales into treasures and make full use of resources reasonably. OBJECTIVE: To verify the hemostatic efficacy, the degradation procedure in vivo, and explore the safety of fish scale collagen. METHODS: Fish scale collagen material was extracted by chemical decalcification combined with low temperature enzymatic method, and used in the following three tests. (1) The First Part: The bleeding test included the body-liver bleeding and surface-tail bleeding. Liver bleeding and tail hemorrhage model was prepared by physical damage to the liver and tail. Model animals were divided into experimental group (use of fish scale collagen), the control group (use of hemostatic sponge), and blank group (no processing). The amount of blood loss and hemostatic time were recorded. (2) Part II: In vivo degradation test of fish scale collagen: Animals with liver hemostasis were euthanized at 1, 3, 5, 10, 20, 30, 40, 50, and 60 days after being filled with fish scale collagen material. Animals in the control group were euthanized at 5 and 50 days after being filled with hemostatic sponge. Animals in the blank group were euthanized at 5 and 50 days after modeling. The adhesions in abdominal cavity were observed, and the degradation of material and the progress of liver regeneration were observed pathologically. (3) Part III: Biological evaluation, including hemolysis test, epidermal stimulation test, intradermal stimulation test, pyrogen test, and acute toxicity test. RESULTS AND CONCLUSION: (1) The collagen of filamentous fish scale was extracted successfully by chemical decalcification combined with low temperature enzymatic method; the yield was 66%-73%, and the pore size of collagen of fish scale was 0.80±0.23 mm. (2) Tail bleeding model was used to verify the hemostatic effect of body surface. Compared with the blank group, the hemostatic time of fish scale collagen was significantly shortened, and the amount of blood loss was significantly reduced compared with the control group (hemostatic sponge) and the blank group (P < 0.05). (3) At 5 days after implantation, the collagen of fish scale was closely attached to the damaged liver without intraperitoneal adhesion. At 20 days after implantation, the volume of collagen of fish scale was significantly reduced; 50 days after implantation, no material was observed by eyes. (4) Pathological examination showed that at 1-3 days after collagen implantation, it was in the stage of acute inflammatory reaction. Cells attached to the material merchant at 5 days. On day 10, vascular structure was formed at the junction of the material and liver. The sinusoid structure of liver was formed in materials at 20-40 days. At 50-60 days, similar hepatic lobule structures could be seen, indicating that the degradation of the material was completed and liver regeneration was basically completed. (5) The results of biological test showed that the hemolysis, epidermal irritation, intradermal irritation, heat source and acute toxicity of collagen of fish scale met the requirements of GB/T16886 Biological Evaluation of Medical Devices. (6) It is concluded that the fish scale collagen extracted by chemical decalcification combined with low temperature enzymatic method has a definite hemostatic effect on bleeding in vivo and on body surface. In vivo degradation time is about 50 days, can provide support for liver regeneration, and is conducive to liver repair. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Data Acquisition & Processing / Shu Ju Cai Ji Yu Chu Li is the property of Editorial Department of Journal of Nanjing University of Aeronautics & Astronautics and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To analyze the value of CT signs in the prediction of disorders of consciousness (DOC) in patients with primary brainstem hemorrhage (PBH). Methods A total of 377 patients with brainstem hemorrhage admitted to the Second Affiliated Hospital of Army Medical University from August 2011 to October 2020 were recruited, and 107 patients with PBH were screened out. According to the level of their consciousness, they were divided into 4 levels, that is, consciousness, somnolence, sopor and coma. Mann-Whitney U and Spearman rank correlation tests were used to perform univariate analysis on the factors that may affect DOC (gender, age, CT signs, bleeding stage), and ordinal multinomial logistic regression analysis was carried out for those with significance (P < 0.05) to explore the correlation of these indicators with consciousness level in order to explore the CT signs that can predict the level of DOC. Results Mann-Whitney U test showed that gender had no significant correlation with DOC, while whether being broken into the ventricle or involved in the midbrain were significantly correlated. Spearman rank correlation analysis indicated that age was not significantly related with DOC, while bleeding stages and average CT values were weakly correlated with DOC, differences of shape and heterogeneity of density were moderately correlated with DOC, and bleeding volume and greatest hemorrhage diameter were highly correlated with DOC. Ordinal multinomial logistic regression analysis showed that: ① The greater bleeding volume or the greatest hemorrhage diameters of the hematoma are, the more serious DOC in PBH patients is. ② The probability of aggravating the DOC level in patients with >5~10 mL brainstem bleeding was 8.05 times higher than that in patients with ≤2 mL bleeding volume. The patients with greatest hemorrhage diameters of >3~4 cm in hematoma had the possibility of aggravating the DOC level at least 1 grade, which was 16.66 times higher than those with ≤2 cm. ③ There were no significant correlations among DOC and the differences of shape, heterogeneity of density, whether the hemorrhage being involved in the midbrain and broken into the brain ventricle or not. Conclusion In PBH patients, bleeding volume and greatest hemorrhage diameters of hematoma are positively correlated with DOC level. Bleeding volume of brainstem bleeding of >5~10 mL or greatest hemorrhage diameter of >3~4 cm indicates the changes of DOC level.

As a green technology, magnetized water (MW) is widely used in the mixing of cement-based materials to improve the performance of the mixture. In the current study, regular tap water (RW) and cement grout are magnetized by lab-built magnetization device. Cement grout samples with water-cement ratios (w/c) of 0.5 and 1.0 were prepared with MW under different magnetization conditions. The stabilities of the cement grouts mixed with RW and MW are measured. The results show that MW has a positive effect on the stability of cement grout. Under different magnetization conditions, the ranges of stability improvement ratios of cement grouts with w/c = 0.5 and 1.0 are 5~67.31% and 0.58~24.16%, respectively. The effects of different magnetization conditions on the stability of cement grout mixed with MW are studied by multiple analysis of variance (MANOVA). The interactions between of magnetization conditions (magnetic induction intensity B, cycle times n, flow speed v) have a great impact on the stability of cement grout and cannot be ignored in the application of magnetized water. A novel attempt was made to magnetize fresh cement grout mixed with RW by a magnetic field, and the results indicate that direct magnetization has no obvious effect on the stability of cement grout.

Objective: This study aims to explore the effectiveness and safety of tranexamic acid (TXA) in reducing the bleeding amount of surgical patients with degenerative spinal disease in the perioperative period.Methods: A total of 80 cases of patients, who underwent elective posterior lumbar interbody fusion surgeries under general anesthesia, were enrolled in this study. The age of these patients ranged within 41–69 years old, and the surgical vertebral body segments were ≥2. The ASA classification was Level I or Level II. These patients were divided into two groups using the random number table (n = 40): TXA group and control group (S group). In the TXA group, the skin was incised after the anesthesia induction, and 20 mg/kg of TXA was immediately injected into the vein. The injection continued at a rate of 10 mg·kg−1·h−1 during the surgery, until the surgery was finished. In the S group, IV and pump injection with an equal amount of normal saline (NS) were performed. Then, the RBC, Hb, HCT, AST, ALT, BUN, Cr, PT, TT, APTT, FIB, and D-dimer were measured before the surgery and at 1 day after the surgery, and the SSFQ, intraoperative bleeding amount, homologous transfusion volume, urine volume, infusion quantity, surgical duration, drainage volume at 24 h after the surgery, total bleeding amount and adverse event occurrence at 1 week after the surgery were recorded.Results: The RBC, Hb and HCT at 1 day after the surgery were higher in TXA group than in the S group (average P < 0.05). Intraoperative bleeding, drainage volume at 24 h after surgery, and total blood loss were lower in the TXA group than in the S group (average P < 0.05). The SSFQ score and length of stay were lesser in the TXA group than in the S group (average P < 0.05). The differences in AST, ALT, BUN, Cr, PT, TT, APTT, FIB, and D-dimer at 1 day after the surgery for these two groups of patients had no statistical significance (average P > 0.05).Conclusion: TXA can reduce the bleeding amount of surgical patients with degenerative spinal disease in the perioperative period and decrease the length of stay, but does not increase the occurrence rate of adverse events, thereby promoting postoperative rehabilitation.Clinical Trial Registration:www.chictr.org.cn/index.aspx, identifier: ChiCTR2000033597.

Copyright of Journal of China Medical University is the property of Journal of China Medical University Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: It is still lack of sufficient clinical evidence whether the patients can benefit from the routine use of elastic bandages after total knee arthroplasty. OBJECTIVE: To explore whether the use of elastic compression bandage after first total knee arthroplasty is beneficial to the prognosis of patients. METHODS: Totally 60 knee osteoarthritis patients who received bilateral knee arthroplasty in the Department of Joint Surgery, West Coast Hospital Branch of Affiliated Hospital of Qingdao University were selected from September 2017 to September 2018. One limb of the patient was covered with a general surgical dressing, while an elastic bandage was applied from the instep to the middle of the thigh (elastic compression bandage group). One limb was covered only with a general surgical dressing (control group). All patients signed the informed consent. The study was approved by the Hospital Ethics Committee. Circumference (thigh, knee and calf), flexural activity (range of motion) and visual analogue scale of the lower extremities were measured at 1, 2, 3 and 7 days after the operation by professionals who were not involved in patient management. Drainage volume 24 hours after operation and the occurrence of complications within 30 days after operation were recorded. RESULTS AND CONCLUSION: (1) At 1, 2, 3, and 7 days after surgery, circumference of thigh, knee and calf was smaller in the elastic compression bandage group than in the control group. Range of motion of the knee was better in the elastic compression bandage group than in the control group (P < 0.001). (2) At 1 and 2 days after surgery, resting visual analogue scale scores were higher in the elastic compression bandage group than in the control group (P < 0.001). At 7 days, resting visual analogue scale scores were lower in the elastic compression bandage group than in the control group (P < 0.001). No significant difference in visual analogue scale scores was found between the two groups at 3 days. Sports visual analogue scale scores in the elastic compression bandage group were higher than in the control group at 1 and 2 days (P < 0.001). However, no significant difference in sports visual analogue scale scores was detected between the two groups at 3 and 7 days. (3) There was no difference in wound-healing complications between the two groups, but the sample size was too small for meaningful statistical analysis. (4) There was a statistically significant difference in drainage volume between the two groups at 24 hours after surgery. (5) No deep infection, venous thrombosis or reoperation occurred within 30 days. (6) It is concluded that the application of elastic compression bandage from the instep to the middle of the thigh after the first total knee arthroplasty can effectively reduce the swelling of the operative limb and postoperative blood loss, increase the flexion and extension of the operative limb, which is conducive to the rapid recovery after the operation. It is worth popularizing and applying. [ABSTRACT FROM AUTHOR]

Intraoperative and postoperative effects of platelet transfusion on antiplatelet drug-related intracerebral hemorrhage (ICH) patients were investigated. A retrospective study on 82 ICH patients undergoing emergency surgical treatment caused by antiplatelet drugs was conducted. Among them, 51 patients treated with platelet transfusion served as the observation group and 31 patients without platelet transfusion as the control group. The intraoperative and postoperative bleeding volume, blood transfusion volume and the rate of secondary bleeding were compared between observation and control group under the guidance of thromboelastography (TEG). The coagulation routine examination results of the two groups before surgery were in the normal range, but TEG indicated an excessive inhibition of platelet function (platelet inhibition rate >89%). The platelet number after treatment increased significantly in the two groups of patients and it was significantly higher in observation group than that in control group (P<0.05). The intraoperative bleeding volume in observation group was significantly lower than that in control group. The total blood transfusion volume in observation group was significantly lower than that in control group (Z=2.681, P=0.036), the postoperative hematoma residual volume in observation group was significantly lower than that in control group (t=2.145, P=0.035), and the drainage volume in observation group was significantly lower than that in control group (t=2.401, P=0.019). Only 3.92% of the patients in observation group and 19.35% in control group had secondary surgery, and the difference of the recurrence rate of secondary bleeding between the two groups was statistically significant (χ2=3.610, P=0.048). TEG detection indicator can more comprehensively and accurately evaluate the preoperative coagulation function of patients. This study suggests that preoperative platelet transfusion can improve the intraoperative and postoperative bleeding of ICH patients after antiplatelet therapy to some extent, reducing the blood transfusion volume and the secondary bleeding rate. [ABSTRACT FROM AUTHOR]

Background: Fibroma, the most common benign pelvic tumor in women, affects 25 to 30% of women of reproductive age. Primary treatment for patients with symptomatic or large fibroma is surgery. Objective: The purpose of this study was to investigate the effect of a single rectal dose of Misoprostol on bleeding during abdominal hysterectomy. Methods: This double blind randomized clinical trial was conducted with 80 candidates for abdominal hysterectomy, due to uterine myoma, in the Shahid Sadoughi hospital of Yazd in 2012. The aim of this study was to assess the effect of single rectal dose of Misoprostol on peri-operational abdominal hysterectomy bleeding. Following administration of 400 micrograms of Misoprostol in the case group (n=40), predetermined criteria were compared with control group (n=40). Results: Volume of bleeding during the operation was significantly lower in cases where Misoprostol was used. (268.71 ± 156.85 vs. 350.38 ± 152.61 cc in the case and control groups, respectively). Our findings also showed that Hemoglobin (Hb) levels before, 8, and 30 hours following the operation differed significantly (p=0.001), but these changes were similar in both groups. Pre-operative Hb levels were 11.90 ± 1.7 and 11.90 ± 2.0 in the case and control groups, respectively. Conclusion: A single rectal dose of Misoprostol has positive effect on reducing peri-operational bleeding in women undergoing abdominal hysterectomy due to symptomatic leiomyoma. Trial registration: The trial is registered at the Thailand Clinical Trial Registry (http://www.clinicaltrials.in.th) with the TCTR identification number TCTR20151011001. Funding: this study funded by Shahid Sadoughi University of Medical Sciences

Objective: To investigate the effect of "U" suture hemostasis on the amount of bleeding in cesarean section of placenta previa patients. Methods: 96 cases of patients undergoing placenta previa cesarean section maternal admitted from September 2015 to September 2017 in our hospital were selected as the research materials and randomly assigned to two groups, with 48 cases in two groups. Both groups of patients were given the routine hemostatic treatment, the control group was given "8" suture hemostasis, the observation group was given "U" suture hemostasis, the index and hemostatic effect were compared between two groups. Results: The operation time, hemostasis time, and intraoperative blood loss of observation group were all significantly less(shorter) than those of the control group(P<0.05), the thrombin time(TT), plasma thrombin reduction time(PT), D-dimer(DD), platelet(PLT), and activated partial clotting activase time(APTT) were significantly lower than those of the control group(P<0.05), the levels of hemoglobin(HGB) and fibrinogen(FIB) were significantly higher than those of the control group(P<0.05), the effective rate of hemostasis[97.92%(47/48)] was significantly higher than that in the control group[(85.42%(41/48)](P<0.05), the time of ambulation and hospitalization were significantly shorter than those of the control group(P <0.05). Conclusion: Implementation of "U" suture hemostasis has the advantages of simple operation in the rapid hemostasis of placenta previa cesarean section, it could reduce the amount of bleeding and ensure maternal health with high safety. [ABSTRACT FROM AUTHOR]

Objective: To investigate effect of tranexamic acid combined rivaroxaban in bleeding volume, coagulation function,knee function in patients with unilateral total knee arthroplasty. Methods: 66 patients who were underwent unilateral total knee replacement in department of orthopedics, PLA 425 hospital from January 2015 to January 2016 were selected as the subjects, and they were divided into treatment group and control group according to random number table method with 33 cases in each group. Patients in the treatment group were injected tranexamic acid in articular cavity before the tourniquet released, patients in the control group were given intravenous drip of sodium chloride injection, and within 6-12 h after operation, patients in both groups were treated with oral rivaroxaban.The total blood loss, occult bleeding volume, blood transfusion rate and blood transfusion volume were recorded and compared between the two groups, the blood coagulation function index, knee function score, knee mobility and visual analogue scale(VAS) were compared between the two groups before and after operation, and the complications of the two groups were observed. Results: Compared with the control group, the total blood loss, occult bleeding volume, blood transfusion and blood transfusion rate of patients in the treatment group were significantly decreased(P0.05). There was no significant difference in activation, partial thromboplastin time(APTT),prothrombin time(PT) and fibrinogen(FG) levels between the treatment group and the control group before and 3 d after operation(P0.05). There was no significant difference in the American Knee Society score(AKSS) and knee joint activity between the two groups before operation(P0.05), 7 d after operation, AKSS score and knee joint activity of patients in the treatment group and the control group were significantly higher(P0.05), and AKSS score and knee joint activity of patients in the treatment group were significantly higher than in the control group(P0.05). There was no significant difference in visual analogue scale(VAS) between the two groups before operation(P0.05), 1 d after operation, VAS scores in the two groups were not significantly different, and compared with before operation(P0.05), 7 d after operation, the VAS score of two groups was decreased compared with before and 1 d after operation(P0.05), but there was no significant difference between the two groups(P0.05). There was no significant difference in the total incidence of complications between the two groups(P0.05). Conclusion: Tranexamic acid combined with rivaroxaban can effectively reduce bleeding in patients underwent unilateral total knee arthroplasty, accelerate the recovery of joint function, and it does not affect the coagulation function of patients, which is worthy of clinical promotion. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to retrospectively evaluate the efficacy and safety of preoperative transcatheter arterial embolization (pTAE) for treating nasopharyngeal angiofibroma (NPAF).Methods: Seventy-four NPAF patients were hospitalized for elective surgical treatment with pTAE (pTAE group, n = 32) or surgical treatment alone (non-pTAE group, n = 42) between January 1990 and December 2013. The following outcome measures were retrospectively analyzed and compared: intraoperative bleeding volume, surgery time (ST), duration of postoperative hospital stay (PHS), and disease recurrence.Results: Among Radkowski stage I patients, those in pTAE group had a slightly higher but not significant bleeding volume than patients in non-pTAE group (344 ± 407 vs. 248 ± 219 mL, P = 0.899); among stage II/III patients, however, patients in pTAE group showed a significantly lower bleeding volume than patients in non-pTAE group (stage II, 829 ± 519 vs. 1339 ± 767 mL, P = 0.035; stage III, 1267 ± 592 vs. 2125  ± 479 mL, P = 0.024). The two groups presented comparable OTs, PHSs, and rates of frontal recurrence (all P>0.05).Conclusions: pTAE significantly reduces intraoperative bleeding in NPAF patients with Radkowski stage II/III disease, but offers no additional benefits regarding ST, PHS, or recurrence. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study is to analyze the effect of 100 mg/d regular oral intake of aspirin during pregnancy on high-risk pregnancy-induced hypertension syndrome patients. PATIENTS AND METHODS: We consecutively selected 98 cases high-risk pregnancy-induced hypertension syndrome patients. After obtaining the informed consent of the patients, we randomly divided the patients into aspirin group (50 cases) and placebo group (48 cases). The oral intake of aspirin lasted from the final diagnosis of pregnancy to antepartum time, and was taken before sleep. The bleeding index was closely detected and we stop taking aspirin when necessary. RESULTS: The comparison of clinical outcome showed that the incidents of pregnancy-induced hypertension syndrome, pre-eclampsia and eclampsia of aspirin group were significantly lower than that of the placebo group (p<0.05). Comparing the complications of fetus perinatal period, the difference was not statistically significant (p>0.05). CONCLUSIONS: 100 mg/d regular oral intake of aspirin during pregnancy is safe, effective and worthy of generalization to high-risk pregnancy-induced hypertension syndrome patients. [ABSTRACT FROM AUTHOR]

Background Fibrinolysis prevents blood clots from growing and becoming problematic. Antifibrinolytics are used as inhibitors of fibrinolysis. Aprotinin was doubted after identification of major side effects, especially on kidney. Lysine analogues has their own defects and whether they are adequate substitutes for aprotinin is still under doubt. Lamiophlomis rotata (Benth.) Kudo. was previous found to have hemostatic activity. But the active compound in L . rotata and its hemostatic mechanism were unknown. Objectives To find the major hemostatic compound in L . rotata and identify its haemostasis mechanism. Methods Traumatic hemorrhage model and coagulant activity assays were monitored in mice and platelets in drug treatment group and control group. Hyperfibrinolysis model was established by intravenous administration of urokinase in mice. Capillary blood clotting time (CBCT), activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), fibrinogen and euglobulin clot lysis time (ECLT) were measured. Results The anti -fibrinolytic activity come from 8-O-Acetyl shanzhiside methylester (ASM) one of the highest iridoid glycosides contents in TIG extracted from L . rotata . ASM significantly (P<0.05) shorten CBCT and reduced blood loss volume in vivo , but did not influence mice APTT, PT or TT. In particular, it significantly prolonged ECLT in hyperfibrinolysis mice. It indicated that ASM could inhibit fibrinolysis. ASM was also effective in CBCT, traumatic bleeding volume and ECLT in hyperfibrinolysis mice model. Conclusions ASM was the major hemostatic compound in L. rotata . The haemostasis mechanism of ASM was achieved by anti -fibrinolytic activity. ASM was a new fibrinolysis inhibitor as iridoid glycoside compound. [ABSTRACT FROM AUTHOR]

Background: Fibroma, the most common benign pelvic tumor in women, affects 25 to 30% of women of reproductive age. Primary treatment for patients with symptomatic or large fibroma is surgery. Objective: The purpose of this study was to investigate the effect of a single rectal dose of Misoprostol on bleeding during abdominal hysterectomy. Methods: This double blind randomized clinical trial was conducted with 80 candidates for abdominal hysterectomy, due to uterine myoma, in the Shahid Sadoughi hospital of Yazd in 2012. The aim of this study was to assess the effect of single rectal dose of Misoprostol on peri-operational abdominal hysterectomy bleeding. Following administration of 400 micrograms of Misoprostol in the case group (n=40), predetermined criteria were compared with control group (n=40). Results: Volume of bleeding during the operation was significantly lower in cases where Misoprostol was used. (268.71 ± 156.85 vs. 350.38 ± 152.61 cc in the case and control groups, respectively). Our findings also showed that Hemoglobin (Hb) levels before, 8, and 30 hours following the operation differed significantly (p=0.001), but these changes were similar in both groups. Pre-operative Hb levels were 11.90 ± 1.7 and 11.90 ± 2.0 in the case and control groups, respectively. Conclusion: A single rectal dose of Misoprostol has positive effect on reducing peri-operational bleeding in women undergoing abdominal hysterectomy due to symptomatic leiomyoma. [ABSTRACT FROM AUTHOR]

OBJECTIVE :To study the effects of magnesium sulfate on bleeding volume and TLH4 level in pregnant women with severe preeclampsia after cesarean section, and to pro into the significance. METHODS: 100 patients with severe preeclampsia admitted into Xiangyang First People’s Hospital Affiliated to Hubei University of Medicine from Sept. 2013 to Sept. 2015 were selected to be divided into observation group and control group via the random number table, with 50 cases in each. After cesarean section, the control group were treated with misoprostol, while the observation group additionally received magnesium sulfate based on the control group. The bleeding volume, changes of blood pressure and adverse drug reactions of two groups were recorder and compared. And the ELISA method was used to detect and compare the serum levels of TLH4 in the serum of women with severe preeclampsia. RESULTS: After treatment, there was no significant difference in systolic blood pressure between before and after treatment in control group(P >0. 05) . but diastolic blood pressure was lower than before treatment, the difference was statistically significant( P < 0. 05 ). The systolic pressure and diastolic pressure of the observation group were lower than before treatment, and the systolic and diastolic blood pressure in the observation group were lower than those in the control group, the difference was statistically significant(p <0. 05 ). In control group, the amount of 0-2 h, the amount of 2-24 h and the total amount of bleeding after cesarean section were higher than those in observation group, the difference was statistically significant(P <0. 05). After treatment, the TLR4 level of peripheral serum in control group was higher than that in observation group, the difference was statistically significant ( P < 0. 05 ). After treatment, individual patients had nausea, vomit and slight fever, which could be relieved after general support treatment; and the other patients had no obvious adverse drug reactions. CONCLUSIONS: Magnesium sulfate can reduce severe preeclampsia maternal serum TLR4 expression to achieve the purpose of treatment of postpartum hemorrhage, and the effects are significant with few adverse drug reactions and high safety; it is worth promoting. [ABSTRACT FROM AUTHOR]

Objectives: Our goal was to develop high throughput computer vision (CV) algorithms to detect blood stains in thoracoscopic surgery and to determine how the detected blood stains are associated with postoperative outcomes., Methods: Blood pixels in surgical videos were identified by CV algorithms trained with thousands of blood and non-blood pixels randomly selected and manually labelled. The proportion of blood pixels (PBP) was computed for key video frames to summarize the blood stain information during surgery. Statistical regression analyses were utilized to investigate the potential association between PBP and postoperative outcomes, including drainage volume, prolonged tube indwelling duration (≥5 days) and bleeding volume., Results: A total of 275 patients undergoing thoracoscopic lobectomy were enrolled. The sum of PBP after flushing (P &lt; 0.022), age (P = 0.005), immediate postoperative air leakage (P &lt; 0.001), surgical duration (P = 0.001) and intraoperative bleeding volume (P = 0.033) were significantly associated with drainage volume in multivariable linear regression analysis. After adjustment using binary logistic regression analysis, the sum of the PBP after flushing [P = 0.017, odds ratio 1.003, 95% confidence interval (CI) 1.000-1.005] and immediate postoperative air leakage (P &lt; 0.001, odds ratio 4.616, 95% CI 1.964-10.847) were independent predictors of prolonged tube indwelling duration. In the multivariable linear regression analysis, surgical duration (P &lt; 0.001) and the sum of the PBP of the surgery (P = 0.005) were significantly correlated with intraoperative bleeding volume., Conclusions: This is the first study on the correlation between CV and postoperative outcomes in thoracoscopic surgery. CV algorithms can effectively detect from surgical videos information that has good prediction power for postoperative outcomes., (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.)

The difference in the course and the lethal mechanism between intracranial, subarachnoid and epidural bleedings was studied in a dog model under varying conditions. Subarachnoid bleedings were usually shortlasting, self-restricting, and generally survivable. The epidural bleedings differed quantitatively and qualitatively from the subarachnoid bleedings in being larger and having a longer duration. The difference seems related mainly to the development of an arteriovenous shunt in the epidural space during the bleeding. It is suggested that the epidural arterio-venous shunt may be of importance for the course and the lethal mechanism in epidural bleeding. [ABSTRACT FROM AUTHOR]

Objective: This study was performed to analyze the relationships of the early glycosylated hemoglobin (GHb) level and blood glucose level (BGL) with prognosis in patients with basal ganglia cerebral hemorrhage (BGCH)., Methods: In total, 186 patients with BGCH were included in this prospective study. The GHb level, fasting BGL, bleeding volume, degree of consciousness disorder, intracerebral hemorrhage (ICH) score, functional outcome in patients with primary ICH (FUNC) score, ICH grading scale (ICH-GS) score, and neurological impairment were recorded during a 30-day observation period., Results: The mean BGCH volume was 58.42 mL. The 30-day mortality rate was 22.32%. The ICH-GS score [odds ratio (OR) = 0.815, 95% confidence interval (95% CI) = 0.504-0.688, R = 0.624] and bleeding volume (OR = 0.882, 95% CI = 0.785-0.918, R = 0.784) were significant predictors of 30-day mortality. The GHb level (OR = 6.138, R = 0.705) and BGL (OR = 1.055, R = 0.418) were independent predictors of 30-day mortality according to the multivariate logistic regression analysis., Conclusion: The GHb level and BGL are strong predictors of 30-day mortality in patients with BGCH and accurately predict the prognosis in these patients.