Cerebral Hemorrhage ; drug therapy ; Humans ; Thrombolytic Therapy

Background: Cardiac surgery with cardiopulmonary bypass (CPB) can cause haemostatic abnormalities that increase the risk of postoperative hemorrhage. Objectives: (1) To study changes of coagulation in cardiac patients undergoing surgery with CPB. (2) To research the relationship between duration of cardiopulmonary bypass, coagulation tests and postoperative hemorrhage complications. Subjects and methods: A cross sectional descriptive study was carried out on 252 patients (105 women, 147 men) undergoing cardiac surgery with CPB due to congenital heart disease and acquired heart disease at Viet Duc Hospital from December 2005 to August 2006. Results: After surgery, 54 patients had to transfuse the blood products, accounting for 21.4% rate. 21 cases had abnormal bleeding (8.3%). 12 patients assigned to re-operate due to bleeding (4.8%). There was an inverse correlation between platelet counts after surgery with duration of CPB and duration of aortic clamping. Relationship between rate of prothrombin, APTT, fibrinogen after surgery and duration of CPB and duration of aortic clamping was not seen. Duration of CPB prolonging over 120 minutes related to postoperative hemorrhage complication (OR=2.69 (p<0.5)). Reduced platelet count increased the risk of postoperative hemorrhage but not statistically significant (OR=1.36; p>0.05). Prothrombin ratio of less than 50% associated with the risk of postoperative hemorrhage (OR=4.83; p<0.01). Conclusion: The routine coagulation tests can help monitor clotting in patients after cardiac surgery
Hemorrhage/ blood ; therapy ; Cardiopulmonary Bypass/ methods

OBJECTIVETo observe therapeutic effects of pricking blood therapy by fire-needle with different bleeding amount on acute gouty arthritis of the foot.

METHODSSix hundred and thirty cases of acute gouty arthritis of the foot were randomly divided into group A, group B and group C according to the visiting sequence. They were treated by fire-needle respectively with 20 mL, 40 mL and 60 mL bleeding amount.

RESULTSThe effective rate in the group A, B and C was respectively 88.1%, 92.8% and 97.6%, the group C being the best, with a very significant difference between the group C and the group A (P < 0.01), and a significant difference between the group C and the group B (P < 0.05).

CONCLUSIONPricking blood therapy is an effective method for acute gouty arthritis of the foot and the therapeutic effect is related with the bleeding amount, the more bleeding amount, the better the therapeutic effect.

No abstract available.
Esophageal and Gastric Varices/*therapy ; Gastrointestinal Hemorrhage/*therapy ; Humans

To systematically review the efficacy and safety of acupuncture combined with minimally invasive surgery or basic the-rapy in treating hypertensive intracerebral hemorrhage(HICH) patients compared with minimally invasive surgery or basic treatment. In this study, the four Chinese databases, the four English databases, Chinese Clinical Trial Registry and ClinicalTrail.gov, all above were systematically and comprehensively retrieved from the time of database establishment to September 10, 2020. Rando-mized controlled trials(RCTs) were screened out according to inclusion criteria and exclusion criteria established in advanced. The methodological quality of included studies was evaluated by the tool named "Cochrane bias risk assessment 6.1". Meta-analysis of the included studies was performed using RevMan 5.4, and the quality of outcome indicators was evaluated by the GRADE system. Finally, 17 studies were included, involving 1 852 patients with HICH, and the overall quality of the included studies was not high. According to Meta-analysis,(1)CSS score of the group of acupuncture combined with minimally invasive surgery or basic therapy was superior to the group of minimally invasive surgery or basic therapy(MD=-3.50,95%CI[-4.39,-2.61],P<0.000 01);(2)NIHSS score of the group of acupuncture combined with minimally invasive surgery or basic therapy was superior to the group of minimally invasive surgery or basic therapy(MD=-4.78,95%CI[-5.55,-4.00],P<0.000 01);(3)the cerebral hematoma volume of the group of acupuncture combined with minimally invasive surgery or basic therapy was superior to the group of minimally invasive surgery or basic therapy(MD=-4.44,95%CI[-5.83,-3.04],P<0.000 01);(4)ADL score of the group of acupuncture combined with minimally invasive surgery or basic therapy was superior to the group of minimally invasive surgery or basic therapy(MD=20.81,95%CI[17.25,24.37],P<0.000 01);(5)the GCS score of the group of acupuncture combined with minimally invasive surgery or basic therapy was superior to the group of minimally invasive surgery or basic therapy(MD=2.41,95%CI[1.90,2.91],P<0.000 01). The GRADE system showed an extremely low level of evidence for the above outcome indicators. Adverse reactions were mentioned only in two literatures, with no adverse reactions reported. The available evidence showed that acupuncture combined with minimally invasive surgery or basic therapy had a certain efficacy in patients of HICH compared with minimally invasive surgery or basic therapy. However, due to the high risk of bias in the included studies, its true efficacy needs to be verified by more high-quality studies in the future.
Acupuncture Therapy ; Humans ; Intracranial Hemorrhage, Hypertensive/therapy* ; Treatment Outcome

Hemorrhage is the second most common cause of death among trauma patients and almost half of the deaths occur within 24 hours after arrival. Damage control resuscitation is a new paradigm for patients with massive bleeding. It consists of permissive hypotension, hemostatic resuscitation and transfusion strategies, and damage control surgery. Permissive hypotension seems to have better results before the bleeding is controlled. The strategy of fluid resuscitation is minimizing crystalloid infusion and increasing early transfusion with a high ratio of fresh frozen plasma to packed red cells. Damage control surgery is done when the patient's condition is unfit for definitive surgery. Hemorrhage and contamination control with temporary abdominal closure is performed before transferring the patients to intensive care unit and the operating room for a permanent laparotomy.
Blood Transfusion ; Fluid Therapy ; methods ; Hemorrhage ; therapy ; Humans ; Isotonic Solutions

OBJECTIVETo approach to the best therapy for acute intracerebral hemorrhage (ICH).

METHODSEighty-five cases of acute ICH were randomly divided into a treatment group (n = 45) and a control group (n = 40). The control group were treated by routine Western medicine, and the treatment group by the medication plus shallow needling.

RESULTSThe total effective rate was 95.5% in the treatment group and 45.0% in the control group with a very significant difference between the two groups (P<0.01).

CONCLUSIONShallow needling and the western medicine have cooperation with a better therapeutic effect in treatment of acute intracerebral hemorrhage.

OBJECTIVETo observe the effect of early acupuncture intervention on brain edema in patients with traumatic intracerebral hematoma and explore its mechanism on the basis of conventional western medicine.

METHODSWith stratified block randomization, sixty-four patients with glasgow coma scale (GCS) of 6 to 12 were divided into an acupuncture combined with medicine group (a combination group) and a western medication group, 32 cases in each one. In the western medication group, dehydration to reduce intracranial pressure and nutritional nerves were given as the basic treatment. In the combination group, on the basis of the treatment as the western medication group, acupuncture was applied at Xuehai (SP 10), Taixi (KI 3), Fenglong (ST 40), Yinlingquan (SP 9), Zusanli (ST 36), etc. The treatment was given once every day, for 6 times as one course; there was an interval of 1 day between two courses; a total of 4 courses were required. GCS score and recovery time were recored before treatment and on the 7 th, 14 th and 28 th days. 90 days follow-up after treatment, the GOS was observed, and the mortality and effective survival rate were calculated. The Barthel index (BI) score was evaluated before treatment and on the 14th, 21st, 28th days and 90 days follow-up after treatment. Before treatment and 3rd, 7th, 14th, 21st, 28th days, cranial CT or MR scan was performed to calculate the brain edema index (BEI); Plasma interleukin-6 (6IL-6), neuropeptide Y (NPY) and nitric oxide (NO) were measured before treatment and on the 3rd, 7th and 14th days after treatment.

RESULTS(1) The GCS scores increased gradually in the two groups during treatment, and there was significant difference between the 28th days and before treatment (both <0.05). There were no significant difference between the two groups about GCS score and average recovery time on the 28th days treatment (all >0.05). (2) The mortality rate of the combination group was 6.3% (2/32) on 90 days follow-up, 9.4% (3/32) in the western medication group (>0.05). The effective survival rate was 81.3% (26/32) in the combination group, which was higher than 59.4% (19/32) in the western medication group (<0.05). (3) The BI score was significantly higher than that before treatment on the 28th days and 90 days follow-up in the two groups (all <0.05), and the result in the combination group was superior to that in the western medication group (both <0.05). (4) The BEI decreased on the 14th, 21st and 28th days in the two groups (all <0.05), and on the 14th day, the BEI decreased more significantly in the combination group than that in the western medication group (<0.05). (5) The levels of IL-6, NPY and NO decreased on the 7th and 14th days in the two groups (all <0.05), and decreased more significantly in the combination group than that in the western medication group on the 7th day (<0.05).

CONCLUSIONOn the basis of conventional western medicine, early acupuncture can reduce cerebral edema and improve the prognosis of patients, and acupuncture combined with medicine are superior to western medicine alone. Acupuncture mechanism may be related to reducing the expression of inflammatory response.

We retrospectively analyzed all patients presenting with upper gastrointestinal bleeding to Seremban Hospital over a one-year period. A quarter of the oesophagogastro-duodenoscopies (OGD) performed were performed as emergency for upper gastrointestinal tract bleeding. Gastric ulcers and duodenal ulcers were the two most common findings. Our results suggest that there is a male preponderance of 2:1, the Chinese were more likely to be affected and the elderly (> 60 years) were at highest risk.
Endoscopy, Gastrointestinal ; Gastrointestinal Hemorrhage/ethnology ; Gastrointestinal Hemorrhage/*etiology ; Gastrointestinal Hemorrhage/therapy ; Malaysia ; Retrospective Studies ; Risk Factors ; Sex Factors

OBJECTIVE: To measure gynecologic resources required to care for women who have unscheduled vaginal bleeding while using hormone replacement therapy. MATERIALS AND METHODS: Between January 1996 to December 1998, women presenting with abnormal withdrawal bleeding on HRT were identified and associated clinic visits and gynecologic procedures were recorded during a mean follow-up of 2 years. RESULTS: Among women using cyclic HRT, 28.9% had> OR =1 visit for unscheduled vaginal bleeding 8.7% had> OR =1 endometrial biopsy. Among women using continuous combined HRT, 19.3% had> OR =1 visit for unscheduled vaginal bleeding and 6.4% had> OR =1 endometrial biopsy. The gynecologic procedures used in women using cyclic HRT were 20% of reassurance, 50% of ultrasonograpy, 30% of endometrial biopsy and in women using continuous combined HRT were 50% of reassurance, 16.6% of ultrasonograpy, 33.3% of endometrial biopsy. The results of endometrial biopsy were reported all the benign condition. CONCLUSION(S): Unscheduled vaginal bleeding markedly decreased after 12 months of therapy in women using continuous combined HRT but did not decline among those using cyclic HRT.
Ambulatory Care ; Biopsy ; Female ; Follow-Up Studies ; Hemorrhage ; Hormone Replacement Therapy* ; Humans ; Uterine Hemorrhage*