Objective To study the therapeutic efficacy of cryoprecipitate in the treatment of disseminated intravascular coagulation(DIC).Methods 28 healed cases of DIC from 2006 to 2007 were enrolled in the study.The changes of thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT)and fibrinogen(Fbg)were compared and analyzed before and after cryoprecipitate infusion.Results The therapeutic efficacy of 28 cases was satisfactory after cryoprecipitate treatment,and the findings of TT,PT,APTT and Fb were improved.Conclusion The cryoprecipitate plays an important role in the treatment of DIC.Cryoprecipitate offers various kinds of blood coagulation factors for control of DIC,provides the opportunity of successful remedy,and improves the treatment achievement ratio.

Purpose:To explore the possibility of non-sent inel lymph node (NSN) metastases in early breast carcinoma patients with positi ve sentinel lymph node (SLN) and its clinical significance. Methods:The incidence and related clinical factors of NSN metas tases were analyzed in 84 early breast carcinoma patients with positive sentinel lymph node, who underwent radical mastectomy. Results:The metastatic NSN was identified in 41 of the 84 pati ents with positive sentinel lymph node (48.8%), the incidence of NSN metastases was related to primary tumor size, SLN metastatic focus size and HER-2 expressi on status, the incidence rate of NSN metastases is proportional to the size of t he primary tumor and metastatic SLN focus, patients with positive HER-2 expres sion have a high NSN metastases rate. Conclusions:The early breast carcinoma patients with

Objective To evaluate special diagnosis and treatment of occult breast cancer. MethodsDiagnostic means used included breast roentgenography,selective mammary ductography, fine needle aspiration and excision biopsy in 28 cases. ResultsBreast roentgenography detected 4 cases ( 7/16), selective mammary ductography identified 4 cases(4/6). The definite diagnosis rate by lump biopsy and immunohistochemistry was 10 cases (10/13). Postoperative follow-up was abtained in 18 cases,with 5 dying of recurrence or distant metastases. Among them 4 patients underwent only axillary node excision. Conclusion Nipple discharge,localized thickening the gland are very important clue to the diagnosis of occult breast cancer.Lump biopsy and immunohistochemistry is a mainstay for the final establishment of the diagnosis of breast cancer. Radical or modified radical mastectomy with adjuvant radiotherapy and chemotherapy is a suitable treatment modality for occult breast cancer.

Objective To investigate the difference of surgical efficacy between extended lymph node dissection and standard lymph node dissection in laparoscopic radical cystectomy.Methods We retrospectively analyzed 62 bladder cancer cases,icluding 52 males and 10 females patients in our hospital from January 2011 to October 2016,who underwent laparoscopic radical cystectomy and pelvic lymph node dissection.Their mean age was (62.5 ± 9.6) years,ranged from 42 to 83 years.27 cases were underwent extended lymph node dissection and 35 cases were underwent standard lymph node dissection respectively.The basic characters,operative time,intraoperative blood loss,intraoperative and postoperative complications,postoperative eating time,postoperative activity time,postoperative hospital stay,lymph nodes positive rate,lymph node density,and cancer-free survival were evaluated.Results All patients were underwent successful operation.There was no significant difference in operation time [(326.2 ± 77.5) min vs.(345.5 ± 66.8) min,P =0.297],blood loss [(198.2 ± 77.5) ml vs.(213.7 ± 160.0) ml,P =0.590],intraoperative complications (0/27 vs.5/35,F =0.063),postoperative complications (8/27 and 9/35,P =0.732),postoperative eating time[(4.8 ±2.2)d vs.(4.6 ± 1.9)d,P =0.817],postoperative activity time[(1.9 ± 0.8) d vs.(1.9 ± 0.9) d,P =0.838] and postoperative hospital stay[(15.6 ± 7.5) d vs.(16.0 ± 5.9)d,P =0.483].In this study,994 lymph nodes and 100 positive lymph nodes were dissected.There were significant differences in the number of lymph nodes dissected in the two groups (23.2 ±6.6 vs.10.5 ±3.6,P ＜0.01).40.74％ (11/27) of cases in ePLND were lymph node positive and the lymph node density was 11.7％ (73/626),which was higher than that of the sPLND group (28.57％ vs.7.34％,respectively).In regard to prognosis,the cancer-free survival rate (DFS) of ePLND group was 96％,91％,80％ and 71％ at 3,6,12 and 24 months follow-up respectively.The other group was 97％ 94％,84％,80％ correspondingly.And no significant difference was detected (P =0.546).Although there was no significant difference (P ＞ 0.05),DFS of ePLND group tended to be higher than that of sPLND group in lymph node positive subgroups.Conclusions Extended lymph node dissection and standard lymph node dissection have similar surgical safety and prognosis,and appropriate surgical procedures should be selected according to the patient's condition.

Objective To detect the changes of hemodynamics in patients with portal vein embolization (PVE) before surgery for hilar cholangiocarcinoma, and analyze the relationship between hemodynamics and liver hypertrophy. Methods The clinical data of 21 patients with hilar cholangiocarcinoma who were admitted to the Eastern Hepatobiliary Surgery Hospital from April 2008 to December 2009 were retrospectively analyzed.Relevant hemodynamic variables were detected and analyzed before and 3, 7, 14 days after PVE. Data were processed using Student t test or linear correlation analysis. Results The main portal vein pressure after PVE was (25.9 ± 4.1 ) cm H2O ( 1 cm H2O = 0.098 kPa), which was ( 3.5 ± 2.5 ) cm H2O higher than that before PVE [( 22.4 ± 4.1 ) cm H2O] ( t = - 6. 504, P ＜ 0.05 ). The blood flow velocity in the non-embolized branch of portal vein increased after PVE, and reached peak [(26 ±9)cm/s] at the seventh day after PVE. A positive correlation was found between the hypertrophic rate of the non-embolized lobes and the ratio of embolized lobes to total liver volume ( r = 0. 593, P ＜ 0. 05 ). Conclusion Greater scope of the embolized vascular bed of portal vein induces higher hypertrophic rate of non-embolized liver.

Objective To explore the feasibility of mechanical chest compression to establish a rat model of car?diopulmonary resuscitation ( CPR) . Methods 4?month old healthy male Sprague Dawley rats were randomly divided into control group ( n=6 ) and model group ( n=10 ) . After induction of anaesthesia with 10% chloraldurate ( 3 ml/kg, i. p. ) , tracheal intubation and left femoral artery cannulation were performed. Under electrocardiographic and artery blood pressure monitoring, tracheal obstruction ( TO) was performed to rats in model group. At 2 min after the cardiac arrest ( CA) occurred, CPRs were administered to the rats using a self?made animal chest compressor, which provided chest?com?pression at a rate of 200 bpm. Results Shortly after TO, rats in the model group had respiratory arrest, cyanosis and ar?rhythmia. Electrocardiography indicated that CA occurred within 4-5 min, with a decreased artery systolic blood pressure ( <40 mmHg) and a zero pulse pressure. Return of spontaneous circulation ( ROSC) after the CPR was successfully a?chieved in 8 rats (80%), with a transient reperfusion arrhythmia. Finally, 60% of the rats (n=6) recovered to con?sciousness and survived for 24 hrs. The serum biochemical analysis indicated that there were electrolyte disturbances, aci?dosis, impaired renal functions and increased myocardial enzyme spectrum. Pathological examination revealed cardiac rhab? domyolysis, no?reflow phenomenon in renal glomeruli, decrease of neurons and pulmonary congestion in the model group rats. Conclusions Mechanical chest compression can provide minimal cardiac output for the requirement of CPR incardiac arrestin rats. It is feasible to establish rat CPR model with the mechanical chest compression.

Drug-induced immune hemolytic anemia (DIIHA) is a rare cytopenia caused by damage to RBCs by drug-induced antibodies or non-immune protein adsorption (NIPA). The drugs associated with DIIHA and the mechanistic hypotheses that are thought to be involved have been controversial, with complex serological tests often required by specialized Immune Hematology laboratories for diagnosis. It is necessary to know the clinical manifestation and laboratory diagnosis of DIIHA in order to distinguish the immuno-hematological abnormality caused by drugs from other causes. How to improve the diagnostic ability of DIIHA and establish a scientific and reasonable idea of DIIHA serological examination is urgent to help clinical diagnosis and correct treatment.

Objective:To investigate the impact of cleavage factor Im25(CFIm25)on VSMCs-specific knockdown in the context of hyperlipidemia.Methods:Mice models were constructed with specific knockout of CFIm25 in VSMCs(CFIm25f/+ TaglnCre)and control mice(TaglnCre).The mice were fed a normal diet or high-fat diet(HFD)for 18 weeks and their body weight changes were monitored.ELISA was used to measure serum total cholesterol(TC), triacylglycerol(TG), high-density lipoprotein(HDL-C)and low-density lipoprotein(LDL-C)levels.The extent of aortic lipid deposition in mice was assessed by oil red O staining.Results:During the feeding of a high-fat diet, CFIm25f/+ TaglnCre mice showed a significant increase in body weight compared to the control group[Male(1.01±0.06)g and(0.87±0.31)g, t=7.53, P<0.05; Female: (0.64±0.02)g and(0.35±0.04)g, t=9.68, P<0.05].After 18 weeks of high-fat diet feeding, CFIm25f/+ TaglnCre mice had significantly higher levels of TC[(6.80±0.35)mmol/L and(3.76±0.87)mmol/L, t=5.63, P=0.004], TG[(0.97±0.21)mmol/L and(0.42±0.10)mmol/L, t=4.08, P=0.015], and LDL-C[(5.20±0.30)mmol/L and(2.00±0.98)mmol/L, t=5.40, P=0.006]compared to the TaglnCre group.Specifically, TC levels increased by 80.72%, TG increased by 132.79%, and LDL-C increased by 160.32%.There was a significant increase in aorta lipid deposition and atherosclerotic plaque area in CFIm25f/+ TaglnCre mice( P<0.05). Conclusions:The research indicated that VSMCs-specific CFIm25 knockdown in mice further worsened hyperlipidemia and atherosclerotic lesions.

Objective To discuss the effect and value of wrapping ureter by a pedicled gastrocolic omentum flap during cutaneous ureterostomy as urinary diversion after radical cystectomy.Methods The clinical data of 12 cases(7 males and 5 females)with bladder cancer during January 2016 and September 2017 were retrospectively analyzed.The median age was 77 years (range 75-83),and the course of the disease was 5 days to 2 years.11 cases had gross hematuria,5 cases had frequent and urgent urination,1 case had lower abdominal pain,and 1 case had no obvious clinical symptoms.9 cases had a history of transurethral prostatic resection.8 cases had a complication of hypertension,5 cases had a complication of diabetes,7 cases had a complication of cardiovascular and cerebrovascular diseases,and 6 cases had a complication of anemia.The ASA level was 3 in 9 cases and was level 4 in 3 cases.All the patiants were diagnosed of bladder urothelial carcinoma by biopsy.There were 8 cases with T3 tumor and 4 cases with T4.All the patients underwent laparoscopic radical cystectomy under general anesthesia,and wrapping ureter by a pedicled gastrocolic omentum flap during cutaneous ureterostomy was used for urinary diversion.Take a segment of 3-5 cm wide pedicle omentum,which is covered from the distal end of the ureter to the end,and use a 4-0 absorbable line to fix the omentum and ureteral outer membrane,and then perform ureterocutaneostomy.The incidence of postoperative anastomotic stenosis,hydronephrosis and wound infection were observed.Results All the operations were performed successfully without obvious operative complications.The mean operating duration was125 (95-217) mins,estimated volume of blood loss 120 (50-600)ml.5 days after surgery,1 patient developed incision infection,which was cured by strengthening anti-infection drug therapy and wound dressing.No complications such as urinary fistula,intestinal fistula and peripheral hernia occurred.No death was reported during perioperative period.Single J tube was removed 1-3 months after surgery.Within a follow-up of 12 (3-23) months,1 case died of cerebral infarction 3 months after surgery,1 case occurred papilla light constriction without special treatment,no ureteral stenosis and necrosis cases and there were no cases of hydronephrosis.All the patients were satisfied with the quality of life after surgery.Conclusions Wrapping ureter by a pedicled gastrocolic omentum flap during cutaneous ureterostomy is simple,safe and effective as urinary diversion after radical cystectomy.

【Objective】 To strengthen the management of transfusion adverse events, so as to reduce the occurrence of medical damage and accidents, and guarantee the safety of blood transfusion. 【Methods】 The adverse events of blood transfusion reported in our hospital from July 2016 to December 2022 were collected, the reasons were tracked, and continuous improvements were made. 【Results】 From 2016 to 2022, a total of 315 transfusion adverse events were reported, including 233(73.97%, 233/315) cases of transfusion reactions and 82(26.03%, 82/315) transfusion adverse events. There were 271 328 transfusion cases in the same period, and the incidence of transfusion reactions was 0.858 7‰(233/271 328). The number of transfusion application was 129 887, and the incidence of transfusion adverse event is 0.631 3‰(82/129 887). Sixty-eigtht(82.93%, 68/82) cases of transfusion adverse events were caused by human factors, while the other 14(17.07%, 14/82) cases were non-human factors. According to the linear regression analysis, we have concluded that the year is a significant indicator for transfusion reaction rates (P<0.05), but not for transfusion adverse event rates (P>0.05). 【Conclusion】 Strengthening the management of reporting adverse events in clinical blood transfusion, monitoring the incidence, analyzing and improving different types of adverse events by management tools can reduce the medical risks of blood transfusion and help to guarantee the safety of clinical blood transfusion.