Objective To investigate the effects of autologous blood withdrawal-reinfusion on the perioperative coagulation function in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB ) . Methods Eighty-four ASA physical status Ⅱ-Ⅳ patients ,without impairment of coagulation function ,scheduled for cardiac surgery with CPB ,were equally and randomly divided into 2 groups using a random number table :autologous blood withdrawal-reinfusion group (group ABWR , n= 44 ) and control group (group C , n= 40 ) . Decreased coagulation function was diagnosed based on the following two criteria :laboratory standard of decreased coagulation function and clinical signs .After anesthesia and before the beginning of operation (T1 ) ,at 5 min after heparin was reversed with protamine (T2 ) ,at the end of operation (T3 ) and at 24 h after the end of operation (T4 ) ,venous blood samples were obtained to measure the blood routine and parameters of coagulation function . Blood routine included the red blood cell (RBC ) , hemoglobin (Hb ) , hematocrit (Hct ) , platelet count , and plasma fibrinogen concentration (Fib) .The parameters of coagulation function included thrombelastography (TEG) variables and prothrombin time (PT ) ,activated partial thromboplastin time (APTT ) ,international normalized ratio (INR ) , and activated clotting time (ACT ) . The volume of intraoperative blood loss , amount of mediastinal drainage at 6 and 24 h after operation , consumption of tranexamic acid and heparin during operation , and consumption of fibrinogen after operation ,and requirement for transfusion of allogeneic RBCs ,fresh frozen plasma (FFP) and platelet during operation and within 24 h after operation were recorded .The development of decreased coagulation function during operation and within 24 h after operation .Results Compared with group C , perioperative consumption of allogeneic RBCs were decreased ,reaction time (R) measured by celite-activated TEG was increased at T3 (P<0.05) ,and no significant change was found in the blood routine index ,incidence of decreased coagulation function ,volume of intraoperative blood loss ,amount of mediastinal drainage ,consumption of tranexamic acid and heparin , and postoperative consumption of fibrinogen in group ABWR ( P> 0.05 ) . Conclusion Autologous blood withdrawal-reinfusion provides similar effects on coagulation function with allogeneic blood transfusion ,and does not increase the development of decreased coagulation function in patients undergoing cardiac surgery with CPB .

Objective:To summarize the characteristics of chest CT imaging and prognosis of children with necrotizing pneumonia (NP) after flexible bronchoscopy, in order to improve the clinician′s diagnosis and treatment of this disease.Methods:The clinical information, imaging features of the sixty-six patients suffering from NP, who were diagnosed and treated in Qingdao Women and Children′s Hospital from September 2015 to April 2019, were retrospectively analyzed. Fourty-six cases who were treated with flexible bronchoscopy alveolar lavage(treatment group) were comparative analyzed with the left 20 cases who were not treated with flexible bronchoscopy alveolar lavage(control group).Results:In treatment group, all patients appered lung consolidation at early stages, and multiple balloon chambers emerged in consolidation shadows in late period. There was no statistic difference in basic information, clinical manifestations, laboratory examinations and etiology between the control group and treatment group( P>0.05). The treatment group had a lower incidence of pulmonary complications and a higher lung shadow full absorption rate, which showed the statistical difference( P<0.05). Conclusion:The flexible bronchoscopy alveolar lavage plays an important role in the process of treating the children with NP, and chest CT provides reliable imaging evidence in the early diagnosis and prognosis of the NP children.