[Objective] To explore the strategy of blood management in patients with massive transfusion in the frigid plateau region. [Methods] The treatment process of a patient with liver rupture in the frigid plateau region was analyzed, and the blood management strategy of the frigid plateau region was discussed in combination with the difficulties of blood transfusion and literature review. [Results] The preoperative complete blood count (CBC) test results of the patient were as follows: RBC 3.14×10¹²/L, Hb 10⁶ g/L, HCT 30.40%, PLT 115.00×10⁹/L; coagulation function: PT 18.9 s, FiB 1.31 g/L, DD > 6 μg/mL, FDP 25.86 μg/mL; ultrasound examination and imaging manifestations suggested liver contusion and laceration / intraparenchymal hematoma, splenic contusion and laceration, and massive blood accumulation in the abdominal cavity; it was estimated that the patient's blood loss was ≥ 2 000 mL, and massive blood transfusion was required during the operation; red blood cell components were timely transfused during the operation, and the blood component transfusion was guided according to the patient's CBC and coagulation function test results, providing strong support and guarantee for the successful treatment of the patient. The patient recovered well after the operation, and the CBC test results were as follows: RBC 4.32×10¹²/L, Hb 144 g/L, HCT 39.50%, PLT 329.00×10⁹/L; coagulation function: APTT 29.3 s, PT 12.1 s, FiB 2.728 g/L, DD>6 μg/mL, FDP 25.86 μg/mL. The patient was discharged after 20 days, and regular follow-up reexamination showed no abnormal results. [Conclusion] Individualized blood management strategy should comprehensively consider the patient’s clinical symptoms, the degree of hemoglobin decline, dynamic coagulation test results and existing treatment conditions. Efficient and reasonable patient blood management strategies can effectively improve the clinical outcomes of massive transfusion patients in the frigid plateau region.

Objective: To investigate the prevalence and associated factors of eating out among children and adolescents aged 6-17 in Hebei Province, and to explore the association between eating out and overweight/obesity. Methods: Data came from Children and Nurse Nutrition Health Monitoring of China during 2016-2017. Questionnaire surveys and anthropometric measures was conducted among 3 330 children aged 6-17 in 12 survey sites. Multivariate Logistics stepwise regression model was used to analyze the influencing factors of eating out and the relationship between eating out and overweight/obesity. Results: The proportion of eating out was 16.19%, and the rate of overweight and obesity was 29.43%. Multivariate analysis showed that the older children (junior high school students:OR=1.36; high school students:OR=3.57, both P<0.05) and adolescents from highincome families (10 000~<20 000 CNY:OR=1.48; ≥20 000 CNY:OR=2.93, both P<0.05) were more likely to eat out. Children and adolescents living in rural areas (OR=0.20, P<0.01), nononlychild (OR=0.76, P=0.02), day school students (OR=0.21, P<0.01), and the primary caregivers of the elderly (OR=0.69, P=0.03) were less likely to eat out. In addition, eating out was statistically associated with an increased risk of overweight and obesity (OR=1.31, P<0.01). Conclusion Eating out is common among children and adolescents aged 6-17 in Hebei Province. Residency, age, household income, onechild family, boarding and and eating out behaviors of primary caregivers are associated with eating out among children and adolescents. Eating out may increase the risk of overweight/obesity in children.

Objective    To investigate the effect of artificial colloid on coagulation function in pediatric patients weighing less than 5 kg with congenital heart disease during cardiopulmonary bypass in congenital heart disease surgery by using artificial colloid instead of human serum albumin. Methods    A total of 65 pediatric patients with weight less than 5 kg who underwent congenital heart disease surgery in our hospital from September 2016 to December 2017 were included in the study. They were randomly divided into two groups: an artificial colloid group (the experimental group, n=33) and a human serum albumin combined artificial colloid group (the control group, n=32). Perioperative hemoglobin concentration (Hb), blood products and hemostatic drugs used, postoperative coagulation function index and pleural fluid volume 24 hours after surgery were monitored. Results    There was no significant difference in perioperative Hb and chest tube drainage between the two groups. The platelet utilization rate in the experimental group was significantly lower than that in the control group (P<0.05). No significant difference was found in the dosage of other blood products and hemostatic drugs between the two groups during the perioperative period. There was no significant difference in coagulation parameters between the two groups before and after surgery (P>0.05). Conclusion    The use of artificial colloid as colloid priming solution during cardiopulmonary bypass has no adverse effect on coagulation function in pediatric patients weighting less than 5 kg with congenital heart disease.

Objective To compare the value of ultrasound guided and CT-guided percutaneous biopsy in diagnosis of chest lesions not blocked by bone nor lung.Methods A total of 244 patients with chest lesions not blocked by bone nor lung were collected and divided into ultrasound-guided group (n=114) or CT-guided group (n=130).The puncture success rate,biopsy success rate and the complication rate were compared between the two groups.Results The puncture success rate (98.25％ [112/ 114]) and biopsy success rate (96.49％ [110/114]) in ultrasound-guided group were higher than those in CT-guided group (86.92％ [113/130],79.23％ [103/130]),and the complication rate (3.51％ [4/114]) in ultrasound-guided group was lower than that in CT-guided group (16.92％ [22/130],all P＜0.01).Conclusion For chest lesions not blocked by bone nor lung,ultrasound is more secure and effective than CT for guiding percutaneous biopsy.

Aim To investigate the effects of red yeast rice capsules containing coenzyme Q10 on femur with an animal model of osteoporosis, which was induced by OVX with D-galactose in rats, and the results were compared with those obtained from diethylstilbestrol. Methods Three-month old female Sprague-Dawley rats were randomly divided into sham group ( CON ) , ovariectomized group ( OVX ) , model group ( MOD ) , diethylstilbestrol group( DES) , and red yeast rice cap-sule group( RYR) . After 60 days, the left femurs were collected for Ca, P and hyp measurement, while the right femurs were performed with three-point bending test and micro-CT evaluation, respectively. Results Compared with CON group, MOD group had a signifi-cant increase in body weight, Tb. Sp, SMI and signifi-cant decrease in maximum load, stiffness, maximum strength, break strength, elastic modulus, Ca, P, Hyp contents and indicators of BV/TV, Tb. N, BMD, Conn-Dens. On the other hand, compared with MOD group, RYR group had a lower body weight and all bone biomechanics indexes were increased without sta-tistically significant difference. At the same time, the content of Ca, P and indicators of BV/TV, Tb. N, Tb. Th, BMD, Conn-Dens increased significantly;yet Tb. Sp decreased significantly. In DES group, the results of indicators were consistent with those for RYR group. In addition, compared with DES group, in RYR group body weight decreased significantly;the content of Ca, P and indicators of BV/TV, Tb. N, Tb. Th, Conn-Dens were significantly higher, and Tb. Sp, SMI were significantly lower. Conclusions Significant bone loss and deteriorated mechanical properties of femur can be observed in animal model of osteoporosis induced by OVX combined with D-galactose. Red yeast rice cap-sules containing coenzyme Q10 show effective prevention effects. Furthermore, red yeast rice capsules(0. 5 tab-let·kg-1 ) have better effect on increasing the number of trabecular bone than diethylstilbestrol ( 30 μg · kg-1 ) does.

Aim To investigate whether D-galactose cause osteoporosis and the difference compared with the osteoporosis induced by ovariectomy, and to deter-mine whether ovariectomy coupled with D-galactose ac-celerated the progress of osteoporosis and whether es-trogen had a preventive effect on these osteoporosis models. Methods Sixty SPF mice were randomly divided into six groups , namely sham-operated group, D-galactose group, OVX group, OVX + D-galactose group, OVX + D-galactose + diethylstilbestrol group and D-galactose + diethylstilbestrol group. Seventy days later, the right tibia was processed with undecal-cified sections for bone histomorphometric analysis. Results Compared with the sham-operated group, %Tb. Ar, Tb. Th and Tb. N decrease by 50. 4%, 25. 4%, 50. 9% ( P <0.01 ) respectively, Tb. Sp in-creased by 169. 4% (P <0.05), Oc. pm, Oc. No. ,%Oc. S, Oc. N/mm which reflected bone absorption significantly increased ( P < 0.01 ) , and % L. Pm, MAR, BFR/TV, BFR/BV, BFR/BS which reflected bone formation significantly decreased ( P <0.01 ) in OVX group. %Tb. Ar decreased by 30. 4% in D-ga-lactose group, but there was no statistically significant difference. However, the four parameters reflected the bone absorption in D-galactose group increased signifi-cantly ( P<0.05 ) , while the four parameters reflected bone formation decreased significantly ( P < 0.05 ) . OVX+D-galactose group has obvious performance of osteoporosis, but there was no significant difference compared to OVX group, nor to D-galactose group. Estrogen had significant preventive effect on related pa-rameters of osteoporosis induced by D-galactose and o-variectomy coupled with D-galactose. ConclusionsOsteoporosis model of mice can be established by OVX, D-galactose and OVX +D-galactose. Estrogen can effectively prevent bone loss induced by D-galac-tose and OVX+ D-galactose.

Objective To study the value of spiral CT in diagnosing renal cell carcinoma(RCC) and to evaluate the correlation of CT findings with histopathologie features in RCC. Methods 279 cases with RCC proven by surgery and pathology underwent plain and contrast-enhanced CT examinations. The clinic characteristics and CT findings were analyzed statistically and compared with surgical results. Results 90.32% lesions showed medium or obvious enhancement on contrast-enhanced CT,with the exception of granule cells for enhanced uniform, the other cell type of RCC showed heterogeneous enhancement. 32.26% of tumors was of more or less short-burres (χ~2 = 38.2,P<0.01) ,and the there was significant relationship between pathological signs of short burr and the renal capsule involved by tumors. CT qualitative diagnostic rate was 91.40%. CT staging and pathologic staging were of the correla-tive coefficient of 0. 84, while there was not obviously correlation between CT classification of RCC and cancer cell types(P>0.05). Conclusion Spiral CT can better show characteristics of RCC, that can improve the diagnostic accuracy and staging aility for RCC.

The P85 regulatory subunit protein and gene expression and P110 catalylic subunit activity of phosphatidylinositol 3-kinase (PI-3K) were investigated in adipose tissue of patients with gestational diabetes mellitus (GDM) in order to explore the molecular mechanisms of insulin resistance (IR) of GDM. Samples from patients with GDM (n=50), and controls (n=50) were collected. Fasting insulin (FIN) was determined by radioimmunoassay. Fasting plasma glucose (FPG) was measured by oxidase assay. Western blot technique was used to detect the levels of PI-3K P85 subunit in adipose tissues of patients with GDM. The mRNA expression of PI-3K P85 subunit was detected by reverse transcription polymerase chain reaction (RT-PCR) method in the adipose tissue. PI-3K activity was examined by immunoprecipitation, thin-layer chromatography and gamma scintillation counting. The results were analyzed statistically. It was found that the levels of FPG, FIN and HOMA-IR in GDM group were significantly higher than those in control group (all P<0.01). There was no significant difference in the protein and gene expression of PI-3K P85 subunit between GDM group and control group (P>0.05). PI-3K activity was significantly decreased to 82.89% in GDM group as compared with control group (P<0.01) and negatively correlated with HOMA-IR (r=-0.75, P<0.01). It was concluded that PI-3K in GDM patients may be involved in the insulin signaling pathway, resulting in IR of GDM.

The P85 regulatory subunit protein and gene expression and P110 catalylic subunit activity of phosphatidylinositol 3-kinase(PI-3K)were investigated in adipose tissue of patients with gestational diabetes mellitus(GDM)in order to explore the molecular mechanisms of insulin resistance(1R)of GDM.Samples from patients with GDM(n=50),and controls(n=50)were collected.Fasting insulin(FIN)was determined by radioimmunoassay.Fasting plasma glucose(FPG)was measured by oxidase assay.Western blot technique was used to detect the levels of PI-3K P85 subunit in adipose tissues of patients with GDM.The mRNA expression of PI-3K P85 subunit was detected by reverse transcription polymerase chain reaction(RT-PCR)method in the adipose tissue.PI-3K activity was examined by immunoprecipitation,thin-layer chromatography and gamma scintillation counting.The results were analyzed statistically.It was found that the levels of FPG,FIN and HOMA-IR in GDM group were significantly higher than those in control group(all P<0.01).There was no significant difference in the protein and gene expression of PI-3K P85 subunit between GDM group and control group(P>0.05).PI-3K activity was significantly decreased to 82.89% in GDM group as compared with control group(P<0.01)and negatively correlated with HOMA-IR(r=-0.75,P<0.01).It was concluded that PI-3K in GDM patients may be involved in the insulin signaling pathway,resulting in IR of GDM.

The relationship between the expression of resistin in polycystic ovary syndrome (PCOS) and insulin resistance was investigated. The plasma resistin concentrations in 35 patients with PCOS and 40 controls were measured by ELISA. Luteinizing hormone (LH), follicle-stimulating hormone (FSH), and fasting insulin (FIN) were tested by radioimmunoassay. Insulin resistance index (HOMA-IR) was calculated. Fasting plasma glucose (FPG) was determined by oxidase test. Western blot and reverse transcriptase PCR (RT-PCR) methods were used to detect the expression of resistin in adipose tissues. The levels of plasma resistin, LH, LH/FSH and FIN and HOMA-IR in patients with PCOS were significantly higher than those in control group (all P<0.05). Plasma resistin was correlated positively with FPG, FIN, HOMA-IR, LH and LH/FSH (r=0.56, 0.60, 0.65, 0.48, and 0.42 respectively). Resistin protein and mRNA expression levels in patients with PCOS were significantly higher than those in normal tissues (all P<0.01). It was concluded that resistin might be involved in the pathogenesis of insulin resistance of PCOS.