Objective To explore the relationship and clinical significance between the serum levels of oxidized low density lipoprotein (Ox-LDL) and soluble P-selectin (SP-S),and carotid atherosclerosis (CA) in metabolic syndrome (MS) patients.Methods In 103 cases of MS patients and 44 healthy subjects (control group),in MS patients with 3 MS diagnostic criteria for the low risk group (51 cases),with ≥ 4 MS diagnostic criteria for high risk group (52 cases).Carotid artery intima-media thickness (IMT) and plaque was measured by color Doppler ultrasound,serum Ox-LDL,SP-S was determined by enzyme linked immunosorbent assay,and pearson regression analysis of linear correlation and classification of two non condition Logistic was performed.Results The serum levels of Ox-LDL,SP-S,carotid artery IMT in low risk group and high risk group were higher than those in control group [(36.42 ±7.17) μg/L and (54.44± 8.10) μg/Lvs.(30.08±7.15) μg/L,(71.46± 12.52) μ g/Land (89.33±20.28) μg/Lvs.(49.95 ± 12.49) μ g/L,(0.86 ± 0.11) mm and (1.00 ± 0.10) mm vs.(0.69 ± 0.11) mm],the difference was statistically significant (P ＜ 0.01).The incidence of plaque in high-risk group and low-risk group was significantly higher than that in control group [55.8％ (29/52) and 45.1％ (23/51) vs.15.9％ (7/44)],the difference was statistically significant (P ＜ 0.01).Linear correlation analysis results of Pearson display,Ox-LDL was positively correlated with SP-S (P ＜0.01).Conclusion Serum Ox-LDL and SP-S are independent risk factor for carotid atherosclerosis in MS patients,they can evaluate progression of carotid atherosclerosis in patients with MS.

Objective:To investigate the perioperative alterations and management of coagulation function in patients of massive blood transfusion during retroperitoneal tumor (RT)resection.Methods:Fourty-seven RT patients at Peking University International Hospital from Jan 2016 to Dec 2021 undergoing resection with massive blood transfusion more than 20 U within 24 h were reviewed for coagulation function before and after surgery.Results:Intraoperative bleeding was 3 000-25 800 ml, 10 patients had blood loss ≥10 000 ml. During the operation, (25.3±9.9) U of red blood cells were transfused, (2 720±1 369) ml plasma transfused, and (2.4±3.3) U platelets were transfused in 6 patients. Fourty-five patients received intraoperative albumin of (79.5±46.5) g; All 47 patients received fibrinogen of (2.3±1.3) g; Prothrombin complex was given in 45 patients (1 205±807) U. Preoperative hemoglobin was statistically different compared to postoperatively and days 1, 3 and 5 ( W=1 790, P<0.001; W=1 672, P<0.001; W=1 704, P<0.001; W=1 486, P=0.004);As with platelets, the difference was also statistically significant compared to postoperative days 1, 3, and 5 ( W=2 153, P<0.001; W=2 092, P<0.001; W=1 732, P<0.001); Preoperative albumin was different compared to postoperative days 1 and 3 ( W=1 568, P<0.001; W=1 578, P<0.001,); Preoperative fibrinogen was different compared to postoperative day 1 ( W=1 964, P<0.001). PT and APTT were prolonged on postoperative days 1 and 3 ( W=628, P<0.001, W=804, P=0.023) ( W=661, P<0.001, W=796, P=0.02). Patient's preoperative fibrin degradation products and D-dimer were above the normal value and were higher on postoperative days 3 and 5 ( W=498, P<0.001, W=345, P<0.001). Conclusions:Coagulation disorders occur perioperatively in patients with massive transfusion while undergoing surgery for RT.The implementation of ratiional transfusion strategy and close postoperative survey and management of coagulation dysfunction help avoid the coagulation related morbidities.