Hemophilia encompasses a group of hereditary bleeding disorders characterized by impaired clotting factor activity,leading to prolonged clotting times.Patients display a tendency toward clotting issues following minor injuries,and severe cases may experience spontaneous bleeding.Acquired von Willebrand syndrome(AvWS)occurs due to the reduction of von Willebrand factor(vWF)levels,resulting in impaired platelet adhesion to endothelial cells,thereby compromising clotting function and leading to bleeding events.The increasing use of extracorporeal membrane oxygenation(ECMO)in clinical settings has brought attention to ECMO-related AvWS.During ECMO support,patients'blood exposure to high shear forces and non-physiological conditions can exacerbate the reduction of vWF levels,further impacting coagulation function.The precise mechanisms triggering AvWS during ECMO support are not conclusively defined,however,studies indicate that high shear forces and systemic inflammation response syndrome(SIRS)are key factors.Mechanical shear stress induced by ECMO damages endothelial cells,releasing factors associated with von Willebrand disease(vWD).Additionally,ECMO-induced SIRS may further compromise vWF functionality.Understanding these mechanisms is crucial for formulating effective preventive and treatment strategies.Diagnosing AvWS during ECMO support can be complex.Typically,assessing a patient's coagulation function and related factor levels is necessary,while cautious interpretation is vital due to potential ECMO interferences.Treatment strategies for managing AvWS during ECMO support are still under investigation.Some studies suggest that using plasma products may improve coagulation function.However,specific treatment approaches should be tailored to individual patient conditions and adjusted based on close monitoring.In summary,diagnosing and treating AvWS during ECMO support remains complex and challenging.Further research holds promise for better understanding the mechanisms involved and for developing more effective treatment strategies to enhance patient prognosis and quality of life.

Objective To compare the cost-effectiveness of closed-loop versus open-loop infusion of propofol guided by bispectral index (BIS) in elderly patients undergoing abdominal surgery.Methods Sixty American Society of Anesthesiologists physical status Ⅱ patients of either sex,aged 65-75 yr,with body mass index of 18 25 kg/m2,undergoing elective open gastrointestinal tumor resection with general anesthesia,were allocated into closed-loop target-controlled infusion (TCI) group (group C) and open-loop TCI group (group O) using a random number table.Propofol was given using closed-loop TCI,and the target BIS value was set at 45-55 in group C.In group O,the target plasma concentration (2.0-3.5 μg/ml)of propofol was adjusted to maintain the BIS value at 45-55.Remifentanil was given by TCI with the target plasma concentration of 2-8 ng/ml in both groups.The total consumption of propofol and remifentanil,time rate of maintaining BIS value within the target range,development of intraoperative hypertension and hypotension,emergence time,tracheal extubation time,time for recovery of orientation,first ambulation time,time to first flatus and length of postoperative hospital stay were recorded.The development of nausea and vomiting and delirium within 3 days after operation and intraoperative awareness was recorded.The cost of anesthetics and total cost of anesthesia were calculated.Results Compared with group O,the total consumption of propofol was significantly decreased,the total consumption of remifentanil was increased,the time rate of maintaining BIS value within the target range was increased,the emergence time,tracheal extubation time and time for recovery of orientation were shortened,the cost of propofol and total cost of anesthesia were decreased (P＜0.05),and no significant change was found in the cost of remifentanil,incidence of postoperative delirium and nausea and vomiting,first ambulation time,time to first flatus or length of postoperative hospital stay in group C (P＞0.05).Intraoperative awareness was not found in two groups.Conclusion Compared with open-loop infusion of propofol guided by BIS,closed-loop infusion of propofol guided by BIS is a cost-effective method of anesthesia in elderly patients undergoing abdominal surgery.

Translational medicine means that to establish a bridge between fundamental research and clinical medicine through bidirectional translation path in order to promote the translation and application from fundamental research to clinical medicine.The purpose of traditional Chinese medicine (TCM) translational model is to collate and build one multidimensional TCM translational model,rationality carry out the research on TCM translation.Three paths have been confirmed,where are from literature research to clinical verification,from clinical application to clinical verification,and from experiment to clinical verification.In this research,methodology of one path mcntioned above could be established,which is the key technology of translational medicine.Take constipation,insomnia,and post-flu cough as target diseases to investigate the herbal compounds which could be qualified for clinical application based on preliminary work.This research not only provided clinical data to TCM translation,but also established one methodology of TCM translation path--"from experiment to clinical verification".

OBJECTIVETo investigate the relationship between acute graft rejection early after renal transplantation and the variations of platelet parameters.

METHODSWe retrospectively analyzed the clinical data of 167 renal transplant recipients before and within 2 months after the surgery. Before and at 1-10 days, 15 days, 30 days, 45 days and 60 days after the transplantation, 5 platelet parameters, including platelet count (PLT), platelet hematocrit (PCT), mean platelet volume (MPV), platelet volume distribution width (PDW), and large platelet ratio (P-LCR), were detected in the 35 patients with acute graft rejection within two months (AR group) and in the other 132 recipients with good graft recovery (control group).

RESULTSThe AR group and control group showed no significant difference in PLT, PCT, MPV, or P-LCR before the surgery, but the PDW was significantly higher in the AR group (t=2.18, P=0.035). These parameters were similar within 5 postoperative days between the two groups (P>0.05), but in postoperative days 6-15, the AR group showed significantly increased MPV, PDW and P-LCR compared with the control group (P<0.05). In postoperative days 6-9, MPV, PDW and P-LCR became stable in AR group but tended to decrease in the control group, showing obviously different patterns of variation between the two groups (P<0.05).

CONCLUSIONSPreoperative PDW may have a positive correlation with acute graft rejection after renal transplantation. Monitoring the variations of MPV, PDW and P-LCR may help in the diagnosis of acute graft rejection early after renal transplantation.

Blood Platelets ; cytology ; Graft Rejection ; blood ; Hematologic Tests ; Humans ; Kidney Transplantation ; Platelet Count ; Retrospective Studies

OBJECTIVETo investigate trend of dietary nutrient intake among adult females in China.

METHODSThe changes of dietary energy and major nutrient intake among females aged 25 to 55 years in 9 provinces were analyzed by using the data from Chinese Health and Nutrition Survey, 2000-2011 (CHNS) and indicators of Chinese Dietary Reference Intakes (DRIs) 2013.

RESULTSDuring the past decade, the proportion of females with the intake of energy and protein meeting the requirement of recommendation decreased, while the proportion of females with low carbohydrate (< 50% energy) and high fat (> 30% energy) intakes increased. Meanwhile, the vitamin and mineral intakes among the females were also unsatisfactory, only small proportion of the females met the requirement for micronutrient intake, and this proportion continued to decline. In 2011, the proportion of the females who met the requirements for energy and protein intakes were 43.0% and 54.4%, respectively; the proportion of the females with low carbohydrate and high fat intakes were 40.2% and 63.8%, respectively; the proportion of females who met the requirements for vitamin A, thiamine, riboflavin, niacin, vitamin C and vitamin E intakes were 25.2%, 10.7%, 6.9%, 54.9%, 24.3% and 88.5% respectively and the proportion of females who met the requirements for calcium, magnesium, iron, zinc and selenium intakes were 3.3%, 23.6%, 50.9%, 75.7% and 13.3% respectively.

CONCLUSIONFurther nutritional education and intervention is needed to improve nutrition status among Chinese females.

Adult ; Ascorbic Acid ; administration & dosage ; Calcium, Dietary ; administration & dosage ; China ; Diet ; trends ; Energy Intake ; Female ; Humans ; Iron ; administration & dosage ; Micronutrients ; administration & dosage ; Middle Aged ; Nutrition Surveys ; Nutritional Requirements ; Nutritional Status ; Vitamins ; administration & dosage

Objective:To assess the possibility of suicide in setting condition among urban and rural residents samples in northern China.Methods:By randomly sampling,1007 persons aged 18 years or older were selected from 10 urban neighborhoods in Beijing and from 10 rural village in Hebei province.The Survey Schedule of Atti-tudes in China in which 24 negative life events were listed,and the possibility of committing suicide was asked to the subjects when they encountered the supposed events.Results:The rates of thinking about committing suicide when encountered the supposed life events were 65.2% of incurable illness,62.0% of burden on other and no future hope,61.2% of drug dependence,57.3% of large debt due to gambling,54.2% of being raped, 51.6% of severe depression,50.7% of being elderly and no family to provide support.Only 14.6% of the ur-ban and rural residents would not consider suicide when encountered any type of supposed problems.Conclusion:There is higher possibility of considering suicide in urban and rural residents when encountered negative life events, so it is important to give support to the residents with one or more life events.

Objective To investigate trend of dietary nutrient intake among adult females in China. Methods The changes of dietary energy and major nutrient intake among females aged 25 to 55 years in 9 provinces were analyzed by using the data from Chinese Health and Nutrition Survey,2000-2011 (CHNS) and indicators of Chinese Dietary Reference Intakes (DRIs) 2013. Results During the past decade,the proportion of females with the intake of energy and protein meeting the requirement of recommendation decreased,while the proportion of females with low carbohydrate(<50%energy)and high fat(>30%energy)intakes increased. Meanwhile,the vitamin and mineral intakes among the females were also unsatisfactory,only small proportion of the females met the requirement for micronutrient intake,and this proportion continued to decline. In 2011,the proportion of the females who met the requirements for energy and protein intakes were 43.0% and 54.4%,respectively;the proportion of the females with low carbohydrate and high fat intakes were 40.2%and 63.8%,respectively;the proportion of females who met the requirements for vitamin A, thiamine,riboflavin,niacin,vitamin C and vitamin E intakes were 25.2%,10.7%,6.9%,54.9%,24.3%and 88.5% respectively and the proportion of females who met the requirements for calcium, magnesium,iron,zinc and selenium intakes were 3.3%,23.6%,50.9%,75.7%and 13.3%respectively. Conclusion Further nutritional education and intervention is needed to improve nutrition status among Chinese females.

Objective To investigate the relationship between acute graft rejection early after renal transplantation and the variations of platelet parameters. Methods We retrospectively analyzed the clinical data of 167 renal transplant recipients before and within 2 months after the surgery. Before and at 1-10 days, 15 days, 30 days, 45 days and 60 days after the transplantation, 5 platelet parameters, including platelet count (PLT), platelet hematocrit (PCT), mean platelet volume (MPV), platelet volume distribution width (PDW), and large platelet ratio (P-LCR), were detected in the 35 patients with acute graft rejection within two months (AR group) and in the other 132 recipients with good graft recovery (control group). Results The AR group and control group showed no significant difference in PLT, PCT, MPV, or P-LCR before the surgery, but the PDW was significantly higher in the AR group (t=2.18, P=0.035). These parameters were similar within 5 postoperative days between the two groups (P>0.05), but in postoperative days 6-15, the AR group showed significantly increased MPV, PDW and P-LCR compared with the control group (P<0.05). In postoperative days 6-9, MPV, PDW and P-LCR became stable in AR group but tended to decrease in the control group, showing obviously different patterns of variation between the two groups (P<0.05). Conclusions Preoperative PDW may have a positive correlation with acute graft rejection after renal transplantation. Monitoring the variations of MPV, PDW and P-LCR may help in the diagnosis of acute graft rejection early after renal transplantation.

Objective To investigate the relationship between acute graft rejection early after renal transplantation and the variations of platelet parameters. Methods We retrospectively analyzed the clinical data of 167 renal transplant recipients before and within 2 months after the surgery. Before and at 1-10 days, 15 days, 30 days, 45 days and 60 days after the transplantation, 5 platelet parameters, including platelet count (PLT), platelet hematocrit (PCT), mean platelet volume (MPV), platelet volume distribution width (PDW), and large platelet ratio (P-LCR), were detected in the 35 patients with acute graft rejection within two months (AR group) and in the other 132 recipients with good graft recovery (control group). Results The AR group and control group showed no significant difference in PLT, PCT, MPV, or P-LCR before the surgery, but the PDW was significantly higher in the AR group (t=2.18, P=0.035). These parameters were similar within 5 postoperative days between the two groups (P>0.05), but in postoperative days 6-15, the AR group showed significantly increased MPV, PDW and P-LCR compared with the control group (P<0.05). In postoperative days 6-9, MPV, PDW and P-LCR became stable in AR group but tended to decrease in the control group, showing obviously different patterns of variation between the two groups (P<0.05). Conclusions Preoperative PDW may have a positive correlation with acute graft rejection after renal transplantation. Monitoring the variations of MPV, PDW and P-LCR may help in the diagnosis of acute graft rejection early after renal transplantation.

OBJECTIVETo investigate the effects of donor and recipient anti-major histocompatibility complex class I-related chain A (MICA) antibodies on early renal graft function in renal transplant recipients.

METHODSUsing Luminex200 liquid chip technology, we detected anti-MICA antibodies in 26 deceased donors paired with 43 recipients. We divided the 43 pairs into 4 groups according to different donor and recipient anti-MICA antibody positivity statuses and compared the incidence of acute rejection (AR), serum creatinine at 1 week after transplantation, and renal function recovery time between the groups to assess the effect of donor and recipient anti-MICA antibodies on early graft function.

RESULTSFive of the 26 donors were positive for anti-MICA antibodies (19.2%), with the most common antibody being anti-MICA*019 (40%); 11 of the 43 recipients were positive for anti-MICA antibodies (25.6%), among which anti-MICA*018 was most frequently found (14.6%). AR did not occur in the only anti-MICA antibody-positive recipient receiving an anti-MICA antibody-positive donor graft; AR occurred in 2 (33.3%) of the 6 anti-MICA antibody-negative recipients receiving anti-MICA antibody-positive donor graft, in 4 (40%) out of the 10 anti-MICA antibody-positive recipients receiving anti-MICA antibody-negative donor graft, and in 10 (38.4%) of the 26 anti-MICA antibody-negative recipients receiving anti-MICA antibodies-negative donor graft. The incidences of AR were not significantly different between the groups (P>0.05), nor were serum creatinine levels or renal function recovery time at one week after surgery(P>0.05).

CONCLUSIONDonor or recipient anti-MICA antibody positivity does not seem to significantly affect the incidence of AR or renal function recovery early after transplantation to justify the necessity of monitoring donor anti-MICA antibodies. But still, large-sample studies are needed to further investigate the potential impact of donor and recipient anti-MICA antibodies on the outcomes of renal transplantation.

Adult ; Antibodies ; immunology ; Antibody Specificity ; immunology ; Female ; Histocompatibility Antigens Class I ; immunology ; Humans ; Kidney Function Tests ; Kidney Transplantation ; Male ; Middle Aged ; Tissue Donors