Objective To investigate the changes of coagulatory functions in patients with fragmental femoral fractures before operation.Methods Twenty adults patients undergoing fragmental femoral fractures, ASA class Ⅰ , hospitalized on the injury day, were selected as test group (group Ⅰ) . Fifteen healthy adults were selected as control (group Ⅱ). The fasting venous blood samples were taken on the morning of 2nd and 6th day after femoral fracture for measurement of the parameters of thromboelastography (TEG) [including R-time, K-time, alpha angle, maximum amplitude (MA) and elastic shear modulus (G)], D-dimer concentration (D-Di), platelet count (PLC) and platelet aggregation rate (PAgR) .Results The values of TEG parameters, D-Di, PLC and PAgR were in normal ranges in group Ⅱ. Compared with those in group Ⅱ, in group Ⅰ the K time was shortened and alpha angle, MA, G, D-Di increased significantly on the 2nd day after femoral fracture(P

Objective To retrospectively analyze the importance of preoperative ultrasound and D-dimer determination for patients with traumatic fractures so as to evaluate the value of vascular color Doppler ultrasound in diagnosing of vein thrombosis and the correlation between D-dimer level and lower extremity vein thrombosis. Methods The study involved 1000 in-patients with multiple traumatic fractures, femoral fractures, tibial fractures or tibiofibular fractures admitted from March 2008 to April 2009 who were prepared for open reduction surgery. There were 568 males and 432 females, at age range of 20-90 years ( average 54.8 years). Vein D-dimer was examined in the morning on the second day after admission. Vascular color Doppler ultrasound was performed on the lower extremity one day before operation (after the swelling faded away, about 4-10 days after fracture). Results The vascular color Doppler ultrasound on the lower extremity showed vein thrombosis of the lower extremity in 64 patients (6.4%) including 26 patients with iliac- femoral vein thrombosis, 10 with popliteal-tibial vein thrombosis and 28 with gastrocnemius or soleus muscle vein thrombosis. On the second day after operation, out of 736 patients (73.6%) with D-dimer above normal (324 μg/L), 56 patients (7.6%) developed thrombosis afterwards;of 264 patients (26.4%) with normal D-dimer, eight patients (3.03%) developed thrombsis. Incidence of thrombosis in patients with D-dimer above 650 μg/L was higher than that in patients with D-dimer below 650 μg/L (P＜0. 01). Conclusions Preoperative lower extremity vein Doppler ultrasound in traumatic fracture patients can lower the risk of fatal lung thrombosis caused by existing deep vein thrombosis.D-dimer above normal level indicates tendency of thorombosis. However, normal D-dimer still have the possibility to develop thrombosis, which deserves attention.

【Objective】 To investigate the impact of ceasing mutual blood donation on voluntary blood donation in Guangzhou. 【Methods】 The data of blood donation from July 2016 to December 2019 (42-month before and after the official cease of mutual blood donation) in the Blood Collection and Supply System of Guangzhou Blood Center, including whole blood donations and apheresis platelets donations, were collected for interrupted time series analysis by month. Blood donors who donated (either whole blood or platelets) during 2016 were followed up until December 31, 2019, and the re-donation rate was analyzed by Chi-square test, t test and logistic regression analysis. 【Results】 The results showed that ceasing mutual blood donation had a significantly positive effect on the increase of platelet donations, but had no significant effect on whole blood donation. In 2016, whole blood donations and platelet donations were mainly voluntary (86.4% and 60.8%, respectively). In comparison of voluntary blood donation, the overall blood deferral rate(by dual assays) of mutual blood donation was higher (P<0.01), but the difference diminished as they donated twice or more. The re-donation rate of blood donors (mutual non-remunerated, voluntary, or both) all increased after the ceasing of mutual blood donation (mutual non-remunerated, : 4.7% vs 4.0%, χ²=29.8, P<0.01; voluntary: 24.8% vs 9.9%, χ²=17295.3, P<0.01; both: 36.3% vs 28.1%, χ²=29.3, P<0.01). The re-donation rate of mutual platelet donors decreased after the ceasing of mutual blood donation, but the number of voluntary platelet donors increased. 【Conclusion】 The ceasing of mutual blood donation was in favour of voluntary blood donation in Guangzhou since various means had been previously adopted by Guangzhou Blood Center to create a long-term mechanism of voluntary blood donation. The number of voluntary blood donors has increased, and the clinical use of blood has been further guaranteed.