1.Study on the effects of blood coagulation function on the severity and prognosis of the patients with multi-trauma
Yunguang SHI ; Zhigang ZHANG ; Ruiying ZHANG ; Lei LIU
Journal of Navy Medicine 2017;38(2):170-174
Objective To explore the value of trauma-induced blood coagulation dysfunction in the evaluation of severity and prognosis of the patients with multi-trauma.Methods Eighty-two cases of multi-trauma patients admitted into the ICU of the department from June 2013 to January 2015 were chosen as the research subjects.The patients were divided into the trauma-induced coagulopathy (TIC) group(n =37)and the non-trauma-induced coagulopathy (NTIC) group (n =45),by depending on whether or not they had coagulopathy,and they were further divided into the death group (n =25) and the survival group(n =57),in view of prognosis 14 days after injury.Indices such as platelet (Plt),fibrinogen (FIB),prothrombin time (PT),activated partial thromboplastin time (APTT),thrombin time(TT) were measured within 6 hours after admission into hospital.Injury severity scores (ISS) of the subjects were evaluated 12 hours after admission,acute physiological and chronic health evaluationⅡ (APACHE Ⅱ)were performed within 24 hours after admission.Six mouths after injury,the survivors in both the TIC group and the NTIC group had medical follow-ups,and scores of Nottingham health profile (NHP) were evaluated.Results The levels of PLt and FIB in the TIC group were lower than those in the NTIC group,and the levels of PT,APTT and TT in the TIC group were all higher than those in the NTIC group,with statistical significance (P < 0.01).The scores of ISS and APACHE Ⅱ in the TIC group were all significantly higher than those in the NTIC group,also with statistical significance(P <0.05).Fourteen days after injury,16 cases in the TIC group died (43.24%),and in the NTIC group 9 cases died (20%).Statistical significance could be noted when comparisons were made between the 2 groups (P < 0.05).Six months after injury,the NHP scores of the TIC group were (97.85 ±23.17),while those of the NTIC group were (86.24 ±20.16).Statistical significance could also be noted when comparisons were made between the 2 groups(P < 0.05).The levels of PLt and FIB in the death group were all higher than those in the survival group.The scores of PT,APTT and TT in the death group were higher than those in the survival group,and the scores of ISS and APACHE Ⅱ at the time of admission in the death group were all significantly higher than those in the survival group.Statistical significance could be noted,when comparisons were made between the 2 groups (P < 0.01).Conclusion There was a high probability for those patients with multi-trauma to have TIC.Coagulation index was of significant importance to the diagnosis and prognosis of the patients with multiple injuries.
2.A Meta-analysis of the incidence of influenza reported during year 2005 to 2012 in China
Yunguang HU ; Xingli XU ; Jingjing WANG ; Jie SONG ; Yancui WANG ; Haiwei LI ; Longding LIU ; Haijing SHI
Chinese Journal of Microbiology and Immunology 2015;(4):265-270
Objective To investigate the epidemic patterns and the characteristics of influenza in Chi-na through a Meta-analysis based on the studies published in domestic literatures.Methods Related articles published during 2005 to 2012 were screened out from domestic databases and analyzed through a Meta-analysis with Review Manager 5.0 software.Results Twenty-two articles covering 957 901 patients with influenza-like-illness (ILI) and 148 233 pathogen samples were screened out according to the inclusion criteria.No significant difference with the ILI diagnosis rate was found between subjects at age 0-4 years and those at age 15-59 years. Higher ILI diagnosis rates were observed in those two groups as compared with subjects elder than 60 years old. Most of the pathogen samples were carried by subjects aged 25-59 years.More influenza virus strains were isola-ted in 2009 as compared with those of the seven other years (OR=2.25, 95%CI=1.27-3.70).There was sta-tistical difference between the numbers of influenza A H1N1 and seasonal influenza A strains (OR=2.25, 95%CI=1.30-3.91) .Significant difference was also observed between the numbers of influenza A and influenza B strains (OR=4.05, 95%CI=2.53-6.47).Conclusion There was significant difference with the diagnosis rate between subjects aged 0-4 years and those aged≥60 years.More attention should be paid to people at high risk of infection (0-4 years old and≥60 years old) and those at 25-29 years with high mobility and social inter-course for the timely prevention and control of pandemic influenza.The detection rate of influenza virus strains was increased during the outbreak of novel influenza A H1N1 infection in 2009.After that outbreak, the detec-tion rate of novel influenza A H1N1 strains was 2.25 times the rate of seasonal influenza strains.The detection rate of influenza A was 4.05 times the rate of influenza B virus strains.Therefore, it is necessary to strengthen the surveillance for influenza A virus and other epidemic influenza virus strains.

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