1.Effects of hemocoagulase on perioperative blood coagulation in patients undergoing total hip replacement
Xiqiang HE ; Pei WANG ; Hui ZHAO ; Xiaoxiong SUN ;
Chinese Journal of Trauma 2003;0(11):-
Objective To investigate the effects of hemocoagulase in preventing and treating perioperative hemorrhage in patients undergoing total hip replacement and study its effects on perioperative blood coagulation function so as to provide objective basis for better clinical usage of hemocoagulase. Methods Eighty ASA Ⅰ Ⅱ patients undergoing total hip replacement under general anesthesia were randomly and equally divided into two groups, ie, Group Ⅰ (control group) that received normal saline for 4 ml iv and normal saline for 2 ml im 10 minutes preoperatively; GroupⅡ(hemocoagulase group) that received hemocoagulase for 2 kU iv and Hemocoagulase for 1 kU im 10 minutes preoperatively. The perioperative and postoperative bleeding volume was measured respectively; meanwhile, the indices of blood coagulation function were measured during operation, immediately, one and five days after operation. Results (1) The perioperative and postoperative bleeding volume in GroupⅡ was significantly less than that in Group Ⅰ ( P
2.Surgical treatment of central herniation in severely-head injured patients
Shengyu SUN ; Hui MA ; Shaocai HAO ; Hechun XIA ; Zhanfeng NIU ; Liang WU ; Xiaoxiong JIA
Chinese Journal of Trauma 2016;32(6):506-509
Objective To determine the characteristics of treatment and diagnosis,surgical timing and surgical methods in severely head-injured patients with central herniation.Methods Twenty patients with central herniation caused by contusions and lacerations of the bilateral frontal lobes hospitalized from July 2010 to December 2012 were retrospectively reviewed.There were 11 males and 9 females,at mean age of 42 years (range,18-70 years).Injury was caused by traffic accidents in 15 patients,falls in 3 and fighting events in 2.Eight patients were treated immediately on admission and twelve patients underwent emergency operation.All the operations involved simultaneous bilateral craniectomy for decompression,including bilateral decompressive craniectomy in 6 patients and unilateral decompressive craniectomy in 14 patients.Glasgow Outcome Scale (GOS) and Montreal Cognitive Assessment were used to evaluated outcome evaluation and cognitive impairment respectively.Complications were recorded.Results All patients were followed up for 6-12 months (mean,8 months).According to GOS,good recovery was presented in 10 patients,moderate disability occurred in 6,severe disability in 2,vegetative state in 1,and death in 1.Eleven patients suffered severe mental disorders especially personality change and disturbance of intelligence,and restored after 12 months.Five patients were complicated by epilepsy and two hydrocephalus.Conclusions For central herniation in patients with severe head injury,an emergent surgery is necessary if there exist conscious disturbance and pupil aggravations,hematoma enlargement and significant displacement of midline structure.Timely bilateral balance decompressive craniectomy is effective to reduce the mortality and disability and improve quality of life.
3.Trends in clinicopathological characteristics of surgically-treated lung cancer: sex-based heterogeneity
Jie DAI ; Liangdong SUN ; Kaiqi JIN ; Xiaoxiong XU ; Zhao LI ; Xinsheng ZHU ; Linlin QIN ; Bin ZHOU ; Fujun YANG ; Yingran SHEN ; Ming LIU ; Xiaogang LIU ; Peng ZHANG ; Yuming ZHU ; Gening JIANG
Chinese Journal of Thoracic and Cardiovascular Surgery 2022;38(7):396-401
Objective:To explore the sex-based heterogeneity in demographic and pathological trends of lung cancer during the past 30 years.Methods:Patients with primary lung cancer who received surgical treatment in the Department of thoracic surgery, Shanghai Pulmonary Hospital Tongji University from 1989 to 2018 were retrospectively analyzed. The differences between male and female patients in age, smoking history, pathological stage and type were compared. Mann- Kendall trend test was performed for trend analysis. Results:A total of 58 433 patients were included in this study, encompassing 30 729(52.6%) men and 27 , 704(47.4%) women. Compared with male patients, female patients were younger(56.0 years old vs. 59.7 years old), and had a higher proportion of non-smokers(98.3% vs. 52.3%), stage Ⅰ lung cancers(60.6% vs. 49.3%), and adenocarcinoma(93.7% vs. 56.1%, all P-values <0.001). Trend analyses revealed that the proportion of female patients increased year by year, and surpassed males in 2015, with the current ratio of male to female being 1∶1.5. After 2013, the age of onset in females was getting younger, and the average age decreased from 58.7 years old to 54.7 years old( P=0.02). The decrease in the proportion of smoking patients was mainly reflected by male patients(from 68.5% to 31.1%, P<0.01). Stage Ⅰ lung cancers in male and females outnumbered advanced stage in 2012 and 2010, respectively, with a much higher proportion in female patients. Among male patients, adenocarcinoma has replaced squamous cell carcinoma as the most common pathological type since 2012, while in female patients adenocarcinoma remained the most common pathological type of lung cancer, and its proportion continued to increase reaching over 98%. Conclusion:A dramatic change in gender distribution was noticed during the past 30 years. Female patients became the primary population in surgically-treated lung cancers, with a trend of getting younger. The proportion of smokers and squamous cell carcinoma decreased significantly in male patients, and adenocarcinoma has become the most common pathological type of lung cancer. The proportion of stage Ⅰ lung cancers was on a dramatic rise, with the popularization of CT screening for lung cancer.