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Objective To explore the application value of transnasal endoscopy combined with endovascular treatment in the operation of skull base tumors. Methods A retrospective analysis was conducted on the clinical data of 9 patients who underwent endoscopic transnasal resection of skull base tumors and received endovascular treatment at Tianjin Huanhu Hospital from January 2017 to July 2022. To observe the tumor resection and evaluate the postoperative efficacy of nasopharyngeal carcinoma according to the World Health Organization (WHO) solid tumor measurement standards. During the follow- up period, Glasgow Outcome Scale (GOS) was used to assess postoperative neurological function recovery, and record tumor recurrence or progression. Complications related to endovascular treatment, such as pseudoaneurysm, spontaneous cerebral hemorrhage and cerebral infarction, were also recorded. Results Among 9 patients, there were 4 patients confirmed donor artery or internal carotid artery (ICA) rupture by DSA before operation, one case underwent spring coil embolization before operation, one case had a carotid catheter sheath inserted in advance during operation, one case had successful hemostasis with spring coil embolization during operation, one case had successful hemostasis with covered stent implantation during operation, 4 cases had ICA rupture confirmed by DSA during operation, and one case had successful hemostasis with spring coil embolization after DSA confirmation of ICA rupture. The total resection rate was 8/9. During a follow - up of 32.00 (25.00, 48.50) months, all patients did not experience tumor recurrence or progression. At the last follow -up, the GOS scores were 4-5, indicating good recovery of neurological function. A patient with recurrent nasopharyngeal carcinoma who underwent immunotherapy had a recurrent pseudoaneurysm at the distal end of the ICA covered with a stent implanted in the petrous segment. Three months after the stent implantation, the patient underwent external carotid artery - radial artery - middle cerebral artery bypass surgery to successfully stop the bleeding without any postoperative complications. The remaining 8 patients did not experience complications such as spontaneous cerebral hemorrhage or pseudoaneurysm. All patients did not experience complications such as cerebral infarction. Conclusions Evdovascular treatment is helpful in evaluating the relationship between skull base tumors and surrounding blood vessels before endoscopic transnasal resection of skull base tumors. It can effectively block the donor artery, reduce the probability of intraoperative bleeding, effectively treat the rupture of large blood vessels, and reduce the occurrence of serious complications. The efficacy and safety are both high. [ABSTRACT FROM AUTHOR]

随着人口老龄化，长期接受抗血小板治疗的患者在神经外科手术治疗人群中的比例不断增加。抗血小板药物导致的潜在血小板功能低下会影响术中止血效果，并增加术中大出血和术后出血并发症风险。因此，如何在术前快速准确地评估血小板功能，对于全面评估患者止血功能具有重要意义。本文通过总结相关文献，结合血小板功能检测在神经外科的使用现状，分析目前常用血小板功能检测方法的优缺点，介绍改善血小板功能的相关疗法，以期提高神经外科医师对血小板功能的认识。 Abstract: With the aging of the population, the proportion of patients receiving long-term antiplatelet therapy among those undergoing surgical treatment is increasing. Potential platelet hypofunction caused by antiplatelet drugs can affect intraoperative hemostasis and increase the risks of massive intraoperative hemorrhage and postoperative bleeding complications. Therefore, a quick and accurate assessment of platelet function before surgery is of great significance in comprehensively evaluating a patient’s hemostatic function. Based on the summary of relevant literature and the current status of the application of platelet function tests in neurosurgery, this paper analyzed the advantages and disadvantages of the currently commonly used platelet function tests, and introduced relevant therapies to improve platelet function, with the aim of improving the understanding of platelet function among neurosurgeons.

Objective To prepare FLIVIGSII peptide (FI peptide) and investigate its physicochemical properties and hemostatic effect in vivo and in vitro. Methods The self-assembling peptide-based hydrogels were prepared by the FI peptide mixed with water. After gross observation for the hydrogel state of the FI peptide, scanning electron microscopy (SEM) and transmission electron microscopy (TEM) were used for its microstructure, and dynamic light scattering (DLS) was performed for its size. The hemostatic effect of FI peptide after being mixed with blood samples treated with 3.8% sodium citrate was observed, and the microstructure of the blood clot was observed with SEM. CCK-8 assay and hemolysis assay were performed to verify its biocompatibility. After a rat model of hepatic parenchymal perforation and hemorrhage was established, 15 female SD rats (6~8 weeks old, weighing 150 g) were randomly divided into control group, FI peptide group and fibrin sealant group. The hemostatic effect of FI peptide and prognosis was observed and analyzed after treatment in each group, and the hemostatic mechanism was also investigated. Results FI peptides were successfully prepared, and it could rapidly self-assemble into a nanofiber network hydrogel in water, and further cause formation of blood clots. SEM showed that FI peptides self-assembled to form fibrous hydrogels after mixing with water. TEM results verified that the FI peptide formed into nanofibers in a diameter of 13.70±2.31 nm after gelatinization in water, and DLS results verified that the FI peptide formed polydisperse and multi-size nanofibers in water (in a range of 148.2~208.0 nm or 575.0~807.0 nm). The fibrous hydrogel formed by the FI peptide mixed with the blood could envelop the red blood cells, thus form a physical hemostatic barrier to achieve blood clotting in seconds. FI peptide hydrogel had no cytotoxicity to normal hepatocytes (L-O2 cells) and did not cause hemolysis of red blood cells. In in vivo experiment, FI peptide quickly formed nanofiber hydrogel when in contact with blood, thus formed physical hemostasis barrier to achieve hemostasis within a few seconds (hemostasis time < 5 s). Conclusion The FI peptide exhibits a rapid and efficient hemostatic effect, indicating a promising clinical application in the hemostasia of hepatic parenchymal traumatic hemorrhage.

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Copyright of Chinese Journal of Stroke is the property of Chinese Journal of Stroke Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Edulis Fungi is the property of Acta Edulis Fungi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: Moist dressings have been widely accepted, but they usually lack antibacterial properties, and their hemostatic activity and moisture-retention can be further improved. OBJECTIVE: To construct calcium sodium carboxymethyl cellulose/hydroxypropyltrimethyl ammonium chloride chitosan multilayer dressing, and to investigate its physical-chemical properties and evaluate antibacterial, hemostatic and biocompatible performances. METHODS: Calcium sodium carboxymethyl cellulose was prepared by ion exchange method, and calcium sodium carboxymethyl cellulose / hydroxypropyltrimethyl ammonium chloride chitosan multilayer dressing (calcium sodium carboxymethyl cellulose:hydroxypropyltrimethyl ammonium chloride chitosan=2:1, 1:1, 1:2) was prepared based on interfacial polyelectrolyte complexation. The water absorption and water vapor transmission of the multilayer films were determined. Fourier transform infrared spectrometry, scanning electron microscopy and energy dispersive spectroscopy were used to characterize the composition, morphology and structure of the multilayer films. The hemostatic performance, antibacterial activity and cytocompatibility of the multilayer films were evaluated by whole blood clotting, plate counting count and co-culture method, respectively. RESULTS AND CONCLUSION: (1) Fourier transform infrared spectrometry and energy dispersive spectroscopy revealed that multilayer film dressing was successfully constructed. Scanning electron microscopy exhibited that the multilayer film was composed of calcium sodium carboxymethyl cellulose layer, hydroxypropyltrimethyl ammonium chloride chitosan layer and polyelectrolyte complex interface layer, which was formed by interfacial complexation. (2) The three multilayer films absorbed water rapidly in the first 10 minutes, and then the water absorption rate gradually slowed down and showed a stable trend. Compared with the dissolution tendency of pure calcium sodium carboxymethyl cellulose film, the multilayer film could be stable for a long time without collapsing after absorbing water in PBS. The water vapor transmission rates of the three multilayer films were lower than those of pure calcium sodium carboxymethyl cellulose films. (3) Pure calcium sodium carboxymethyl cellulose film had no antibacterial properties. The multilayer film had antibacterial properties. With the increase of the proportion of hydroxypropyltrimethyl ammonium chloride chitosan in the multilayer films, the antibacterial rate against Staphylococcus aureus and Escherichia coli increased. (4) The procoagulant property of the multilayer film (1:2) was weaker than that of the multilayer film (2:1, 1:1) and the pure calcium sodium carboxymethyl cellulose film. (5) CCK-8 assay showed that the proliferation rate of fibroblasts on the multilayer film (1:2) was lower than that on the multilayer film (2:1, 1:1) and pure calcium sodium carboxymethyl cellulose film (P < 0.05). Under the laser confocal microscope, the fibroblasts on the membranes of each group grew well and were spindle or polygonal. (6) The results show that the calcium sodium carboxymethyl cellulose/ hydroxypropyltrimethyl ammonium chloride chitosan multilayer film has good water absorption, moisturizing, hemostatic and antibacterial properties. [ABSTRACT FROM AUTHOR]

Copyright of Advanced Textile Technology is the property of Zhejiang Sci-Tech University Magazines and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Edulis Fungi is the property of Acta Edulis Fungi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: Our previous studies manifested that the absorbable macroporous polysaccharides composite hemostatic material has a good hemostatic effect, but its immunotoxicity has not been further studied. OBJECTIVE: To evaluate the immunotoxicity of absorbable macroporous polysaccharides composite hemostatic materials in mice. METHODS: The 48 BALB/c mice were randomly divided into four groups (n=12). No material was implanted in the subcutaneous capsule in the sham-operated group. Mice in the experimental 1 group were implanted with absorbable macroporous polysaccharides composite hemostatic materials without purification in the subcutaneous capsule. Mice in the experimental 2 group were implanted with absorbable macroporous polysaccharides composite hemostatic materials with purification in the subcutaneous capsule. Mice in the control group were implanted with compound microporous polysaccharide hemostatic powder. At 14 and 28 days after implantation, mass and organ/body weight ratio of the heart, liver, spleen, lungs, kidney, adrenal gland, thymus, testis and epididymis, serum IgG and IgM concentraions, proportion of B cells and T cells in spleen lymphocytes, and pathological changes of spleen and thymus were analyzed. RESULTS AND CONCLUSION: (1) During the experiment, the mice with implanted material were in good condition without obvious poisoning reaction. (2) On day 14 after implantation, the heart weight of the experimental 1 group was higher than that in the sham-operated group (P < 0.05). Lung organ weight and coefficient were lower in the control group than those in the sham-operated group (P < 0.05). Kidney organ weight and coefficient were higher in the experimental 2 group than those in the sham-operated group (P < 0.05). At 14 and 28 days after implantation, other organ weight and coefficient were not significantly different between the experimental 1, 2, and control groups and sham-operated group (P > 0.05). (3) IgM concentration was lower in the experimental 2 group than that in the sham-operated group at 14 days (P < 0.05). IgG concentration was higher in the experimental 1 group than that in the sham-operated group at 28 days (P < 0.05). (4) At 14 and 28 days after implantation, the proportion of B cells and T cells in spleen lymphocytes was not significantly different between the experimental 1 and 2 groups and control group (P > 0.05). (5) At 14 and 28 days, hematoxylin-eosin staining showed slight chronic inflammation in the experimental 1, 2, and control groups. The degree of inflammatory reaction was experimental 2 group < experimental 1 group < control group. (6) These findings verify that absorbable macroporous polysaccharides composite hemostatic material has a low immunotoxicity. [ABSTRACT FROM AUTHOR]

Objective To assess the efficacy of bilateral prostate arteries embolization (PAE) in the treatment of refractory prostatogenic hematuria (RHPO) in the elderly and high-risk patients. Methods From November 2018 to November 2021, 44 elderly patients with high-risk RHPO, who could not tolerate surgery were divided into two study groups. The observation group (22) was treated with bilateral PAE whereas the control group (22) was treated with medications and urethral catheter traction. The success rate of hemostasis, recurrence rate of bleeding, and complications of the two groups were compared to evaluate the efficacy of PAE for RHPO.Results PAE was successful in 21/22 (95.45%) patients with 100% hemostasis at 48 hours. Compared with the control group, PAE group had significantly (all P<0.01) lower rate of rebleeding at 6 months (4.54%), lower incidence of deep vein thrombosis (0%), shorter hospital stay [ (6.25±0.25) days], faster hematuria regression [ (12.25±4.12) hours], higher treatment effective rate (95.45%) than the control group [72.72%, 18.18%, (11.50±0.25) days, (108.15±6.14) hours, 18.18%]. Repeat hospitalization was significantly less in the PAE group than the control group (P<0.05). Conclusion The hemostatic effect of bilateral PAE is reliable with shorter hospitalization and lower rate of recurrent bleeding. It is safe and effective treatment for patients with refractory prostatogenic hematuria. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Medical Equipment Journal is the property of Chinese Medical Equipment Journal Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: Hemostasis is an important part of clinical treatment. Fast and effective hemostasis is necessary to ensure the safety of surgical patients.OBJECTIVE: To prepare a kind of plant polysaccharide hemostatic microsphere with porous structure and its performance evaluation. METHODS: Porous hemostatic microspheres were prepared from potato starch by gelatinization, emulsification crosslinking, cleaning, and drying technique. The hemostatic performance of the hemostatic microspheres was improved by improving the gelatinization and crosslinking processes of the starches, setting the grouping: group A(gelatinization for 1 hour, crosslinking for 6 hours, group B（gelatinization for 1 hour, crosslinking for 12 hours）, group C（gelatinization for 1 hour, crosslinking for 18 hours）, group D（gelatinization for 2 hours, crosslinking for 6 hours）, group E（gelatinization for 2 hours, crosslinking for 12 hours）, and group F（gelatinization for 2 hours and crosslinking for 18 hours）. The listed absorbable hemostatic microspheres were used as controls to examine the microtopography, pH, porosity and in vitro degradation of microspheres in each group. According to the above experimental results, suitable microspheres were selected for hemostasis of liver and spleen in New Zealand rabbits, comparing the sample dosage, hemostasis amount with hemostasis time.RESULTS AND CONCLUSION:（1） Scanning electron microscope showed that group B and group E formed porous microspheres with a stable structure of 50-200 μm in diameter, and the spherical morphology and porosity were better than those of the control group. Except for groups C and E, the pH values of the other samples were in the range of 6.5-7.5, which met the pH requirements. The same quality of samples, the cross-linking time growth and degradation time increased significantly（P < 0.01）. Based on the examination of morphological structure, porosity, pH and in vitro degradation in the previous stage, groups A, B, E and the control group were selected for hemostasis experiments.（2） Under the same hemostatic effect, the hemostatic time of microspheres in group E was shorter and less used compared with that in the control group, and the hemostatic effect in group B was not significantly different from that in the control group.（3） The results showed that the porous starch microspheres prepared after gelatinization at 60 °C for 2 hours, emulsification for 45 minutes, and cross-linking for 12 hours had the best hemostatic effect and its degradation time was also relatively short, and its performance was superior to that of listed products. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To report the first application of bipolar coagulation in separating donor vessels of surgical revascularization and explore the differences with traditional separated techniques. Methods and Results Instruments included high-frequency electrosurgical electric knife with bipolar mode [electric coagulation energy 60-70 W (separation) or 4-8 W (hemostasis)], short bipolar forceps (body length was 12 cm and its tips was coated with strong anti-stick coating, of which diameter was < 0.50 mm) and a short microaspirator tip (its length was 15 cm with 0.50 mm diameter). Initially, the shape of superficial temporal artery (STA) was marked and an incision was made based on surgical types from damaging the root of STA. Following with the fixed flap, bipolar tweezers were employed to separate the artery with 70 W of electric energy. And in this procedure, the arterial pulse and walking was verified by fingers. Afterwards, the surgeon separated donor arteries from the deep connective tissue by short bipolar forceps with lifting vessels away from the flap on the other hand. Of notes, bipolar forceps should avoid direct contact with vessels and the maintain of moist arterial staus also requires in the whole process. In addition, cotton tablets which were soked with fasudil could wrap the donors for rapid angiectasis just in case of strong vasospasm. Conclusions The quality of donor vessels is a primary factor determining the success of cerebral revascularization. In contrast with the traditional separated techniques, short tweezers were applied in the separation of donor vessels with sharp tips, favorable safety, little damages, high power of electrocoagulation and efficiency. Besides, the length of arteries harvested by bipolar coagulation was longer than that by monopolar coagulation, so did with the vascular compliance. Precise coagulation should be applied at a certain distance from targeted blood vessels and a proper amount of soft tissues could be attached to vessels. Once donor arteries or these branches were bleeding, bipolar tips could be employed in the hemorrhagic sites with 6 W of the electric coagulation power softly. Meanwhile, the techniques in the separation of blood vessels by bipolar forceps required high surgical abilities which called for practices. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Medical Equipment Journal is the property of Chinese Medical Equipment Journal Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To evaluate the influence of thromboelastography-guided hemostatic algorithm on allogeneic transfusion requirements during pediatric hemispherectomy. Methods: Clinical data of 38 children who underwent hemispherectomy from January 1, 2011 to October 31, 2023 at Xuanwu Hospital of Capital Medical University were retrospective collected. Patients were divided into study group ( n =17) and control group ( n =21) according to whether thromboelastography was employed to guide hemostatic algorithm. Demographic data and surgical data were recorded. The primary outcomes were allogeneic transfusion rates, including RBC transfusion rate, plasma transfusion rate, and platelets transfusion rate. The second outcomes were estimated blood loss, postoperative seizures during hospitalization, thromboembolic events, and length of hospital stay. Results: There were 13 boys and 4 girls with mean age of (5.7±3.3) years old in study group, and 16 boys and 5 girls with mean age of (7.4±3.4) years old in control group. The surgery duration, anesthesia duration and the proportion of prophylactic administration of tranexamic acid in study group were (424.5±98.5) min, (542.8±106.9) min, and 94.1% (16/17), which were higher than (353.1±85.3) min, (445.3±87.9) min, and 47.6% (10/21) in control group (all P <0.05). The rates of intra- and perioperative allogeneic plasma transfusion in study group were 52.9% (9/17) and 64.7% (11/17) respectively, which were lower than 90.5% (19/21) and 95.2% (20/21) in control group (all P <0.05). The ratio of fibrinogen concentrates administration in study group was 58.8% (10/17), which was higher than that in control group [4.8% (1/21), P =0.001]. There were no statistically differences in intra- and perioperative allogeneic RBC transfusion rates between the two groups (all P >0.05). No platelets were transfused in both groups. There were no statistically differences in estimated blood loss, postoperative seizures during hospitalization and the length of hospital stay between the two groups (all P >0.05). No postoperative thromboembolic events were observed. Conclusion: Thromboelastography-guided hemostatic algorithm can reduce allogeneic plasma transfusion requirements but not RBC transfusion requirements during pediatric hemispherectomy.

BACKGROUND: Ozone has good bacteriostatic and hemostatic effects, but its poor stability and easy decomposition limit its application and promotion. OBJECTIVE: To prepare ozone sustained-release hydrogel, and to evaluate its stability and hemostasis and promoting effect on wound healing. METHODS: (1) With carbomer as the substrate, the ozone sustained-release hydrogels with ozone concentrations of (3.4±0.2)×10-6, (2.3±1.8)×10-6, (7.20±0.5)×10-6, (7.0 ±3.0)×10-6, (16.4±1.2)×10-6, and (15.0±5.0)×10-6 were prepared by controlling the ozone penetration time, and the stability of ozone in the ozone sustainedrelease hydrogel was tested. (2) A total of 15 Sprague-Dawley rats were used to make liver hemorrhage models. They were randomly divided into five groups: the blank control group used ordinary clean gauze to stop bleeding; the positive control group used Celox hemostatic powder to stop bleeding; the low-, medium- and high-concentration ozone gel groups were covered with ozone sustained-release hydrogel containing ozone concentrations of (3.4±0.2)×10-6, (7.20±0.5)×10-6, and (16.4±1.2)×10-6, and the time of hemostasis was recorded. (3) A total of 15 Sprague-Dawley rats were used to make a model of the back skin wound. They were randomly divided into five groups: the blank control group was not treated; the positive control group was coated with Beijing Wanhong ointment; the low-, medium- and high-concentration ozone gel groups were covered with the ozone sustained-release hydrogel containing ozone concentrations of (2.3±1.8)×10-6, (7.0±3.0)×10-6, and (15.0±5.0)×10-6, and wound healing was observed within 14 days. The experimental project was approved by the animal experimental ethics committee of Wuhan University (approval No. 2019010019). RESULTS AND CONCLUSION: (1) Ozone had good stability in hydrogels, which could last for about 2 weeks. (2) In the liver hemostasis experiment, compared with the blank control group, the medium- and high-concentration ozone sustained-release hydrogel and hemostatic powder could shorten the hemostatic time (P < 0.01), and the hemostatic time of the high-concentration ozone sustained-release hydrogel was shorter than that of hemostatic powder (P < 0.05). (3) In the skin wound experiment, compared with the blank control group, medium- and high-concentration ozone sustained-release hydrogel could improve the wound healing rate at 4 days (P < 0.05, P < 0.01); at 14 days, there was no significant difference in wound healing rate among five groups. (4) Ozone sustainedrelease hydrogel has good stability, can promote hemostasis and wound healing. [ABSTRACT FROM AUTHOR]

To investigate the anti-inflammatory, analgesia and hemostasis effects of the 75% alcohol extract from Sargentodoxa cuneata(AESC). The AESC was prepared by ethanol extraction, and its chlorogenic acid content was determined by HPLC. KM mice(or New Zealand rabbits)were randomly divided into the blank group, positive control group(Yunnan Baiyao Tincture group)and the AESC group in determination of anti-inflammatory, analgesia and hemostasis activities. The anti-inflammatory, analgesic and hemostasis effects were investigated through determining xylene-induced ear swelling of mice, pain threshold and rabbit liver bleeding model. The results were as follows: The content of chlorogenic acid was(0.294 ± 0.013 5)%; Compared with the blank group, AESC group(Dose 0.700 g·kg-1)could significantly reduce the ear swelling induced by xylene(P < 0.01), and the inhibition rate was 26.3%; Compared with the blank group and before administration, AESC group(Dose 1.40 g·kg-1)could significantly increase the pain threshold of mice(P<0.01); Compared with the blank group, AESC group(Dose 1.40 g·kg-1)could significantly improve the score of local wound bleeding(P<0.001). The alcohol extracts of S. cuneata showed significant effects in anti-inflammatory, analgesic and hemostasis, could be developed as the anti-inflammatory, analgesic, hemostatic agents. And this study will provides theoretical basis for clinical application of the S. cuneata. [ABSTRACT FROM AUTHOR]

Nanomaterials, with the advantages of unique microstructure, have been widely used in the fields of material manufacturing, microelectronics and computer technology, medicine and health, environment and energy. Compared with traditional hemostatic materials, nanomaterials can improve the bioavailability and stability of traditional hemostatic drugs to a certain extent, enhance the controlled and targeted release of drugs, which lay a good foundation for the development of new-style modern hemostatic nanomaterials. This paper reviews the advanced design and application progress of various nanomaterials in hemostasis, such as liposomes, nanoparticles, self-assembled nano peptides, nanofibers, etc. Finally, the challenges and prospects of hemostatic nanomaterials are briefly described. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Bioprocess Engineering is the property of Chinese Journal of Bioprocess Engineering Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: Tranexamic acid is widely used for its good hemostatic effect in orthopedic surgery, and it is the most mature application in hip and knee arthroplasties. However, the impact on perioperative blood loss of high tibial osteotomy and the risk of deep venous thrombosis is unknown. OBJECTIVE: To explore the effect of tranexamic acid on the perioperative blood loss of high tibial osteotomy and the risk of deep venous thrombosis. METHODS: From June 2017 to December 2019, 76 patients with knee osteoarthritis who underwent high tibial osteotomy in the First Department of Joint Surgery of the Affiliated Hospital of Weifang Medical University were selected as the research subjects. The 76 patients were randomly divided into two groups (n=38). Tranexamic acid saline injection (1 g, 100 mL) was given intravenously 30 minutes before the operation in the trial group, and the same amount of saline was given intravenously in the control group. General perioperative data such as age, sex ratio, body mass index, hemoglobin, hematocrit, fibrinogen, prothrombin time, and activated partial prothrombin time were recorded in both groups. The two groups of patients were operated by the same group of physicians, and the internal fixation was made by the same company. The operation time, intraoperative blood loss and postoperative drainage, blood transfusion, hemoglobin and hematocrit at 1, 3, and 5 days after surgery, coagulation index at 3 days surgery, and venous thrombosis of the lower limbs at 5 days after surgery were recorded. Total blood loss, hidden and dominant blood loss were calculated. RESULTS AND CONCLUSION: (1) The perioperative general information was not statistically significant between the two groups (P > 0.05). There was no significant difference in the operation time between the two groups (P > 0.05). (2) The total blood loss, hidden and dominant blood loss and postoperative drainage volume in the trial group were less than those in the control group (P < 0.05). There was no significant difference in intraoperative blood loss between the two groups (P > 0.05). There was a statistically significant difference in the maximum reduction in hemoglobin and the maximum reduction in hematocrit after surgery between the two groups (P < 0.05). (3) One case in the control group was treated with blood transfusion, accounting for 3%. There was no blood transfusion treatment in the trial group, and the difference between the two groups was not statistically significant (P > 0.05). (4) There was no statistically significant difference in fibrinogen, activated partial prothrombin time and prothrombin time between the two groups at 1, 2, and 3 days after surgery (P > 0.05). (5) One case of urinary tract infection occurred in the control group after high tibial osteotomy, and no other obvious complications occurred. At 5 days after the operation, the color Doppler ultrasound of the lower extremities was reexamined. No deep vein thrombosis of the lower extremities was found in the two groups (P > 0.05). (6) It is concluded that intravenous application of tranexamic acid before high tibial osteotomy in knee osteoarthritis patients can reduce the total blood loss during perioperative period, especially the hidden blood loss, and it will not increase the risk of deep venous thrombosis of the lower extremities. [ABSTRACT FROM AUTHOR]

BACKGROUND: Compared with traditional hemostatic methods, absorbable hemostatic materials are more expensive and have lower awareness, but they have greater advantages in certain surgical procedures. OBJECTIVE: To review the classification, clinical use, safety and development status of absorbable hemostatic materials. METHODS: The computer was used to search the PubMed database for relevant literature published from January 2003 to March 2020. The search terms were “Absorbable Hemostatic Agents; Fibrin adhesives; Hemorrhage; Hemostatic dressings; Hemostats; Mechanical hemostats; Sealants”. China National Knowledge Infrastructure was retrieved for relevant literature published from January 2004 to March 2020. The search terms were “absorbable hemostatic material; hemostatic material; clinical research”. RESULTS AND CONCLUSION: Absorbable hemostatic materials mainly produce hemostasis by accelerating the blood coagulation process of wounds. Common hemostatic products include cellulose, starch and other plant polysaccharides, gelatin/collagen, chitosan, and fibrinogen. Different materials have different hemostatic mechanisms. Oxidized regenerated cellulose, starch, gelatin/collagen and chitosan hemostatic materials mainly form platelets by providing platelet activation and aggregation. Fibrinogen hemostatic materials can be used in the coagulation cascade involved in the formation of fibrin clots. The use of absorbable hemostatic materials depends on the doctor’s experience or preference. Clinicians need to choose one or more hemostatic material combinations according to the actual situation of the patient. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Medical Equipment Journal is the property of Chinese Medical Equipment Journal Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Spontaneous intracerebral hemorrhage (SICH) is a severe subtype of stroke. Hematoma expansion could occur in the short term after symptom onset in most patients, leading to neurological deterioration and mortality. Therefore, early hemostasis treatment is essential to save patients' lives and improve prognosis. Currently, the hemostatic agents used for intracerebral hemorrhage are mainly antifibrinolytic drugs and recombinant activated factor VII. However, there is no decisive evidence for the clinical benefit of hemostatic drugs in patients with intracerebral hemorrhage. To provide reference for clinical choice of drugs, this article reviews the hematoma expansion mechanism and hemostatic therapy of spontaneous intracerebral hemorrhage. [ABSTRACT FROM AUTHOR]

Objective To investigate the risk factors for failure in emergency endoscopic injection sclerotherapy (EIS)combined with sequential histoacryl injection (HI)for esophagogastric variceal bleeding (EGVB) with portal vein embolus (PVE). Methods A total of 109 EGVB patients with PVE who underwent emergency gastroscopy in Beijing Shijitan Hospital, Capital Medical University, and The Fifth Medical Center of Chinese PLA General Hospital from January 2018 to December 2019 were enrolled, and according to the outcome of hemostatic treatment under emergency gastroscopy, the patients were divided into hemostatic failure group with 28 patients and hemostatic success group with 81 patients. The two groups were compared in terms of general information, varices and bleeding manifestations under gastroscopy, blood biochemical parameters, Child - Pugh class, and Model for End - Stage Liver Disease (MELD)score, and the risk factors for hemostatic failure were analyzed. The t - test or the Mann - Whitney U test was used for comparison of continuous data between groups, and the chi - square test was used for comparison of categorical data between groups;a logistic regression analysis was used for multivariate analysis. Results Compared with the hemostatic success group, the hemostatic failure group had significantly higher peripheral white blood cell count (WBC), total bilirubin (TBil), Child - Pugh class, and MELD score (Z = 3. 794, Z = 4. 751, X2 = 40. 104, Z = 6. 412, all P < 0.001)and significantly lower prothrombin time activity (PTA), albumin (Alb), and cholinesterase (CHE)(t =9. 653, Z =3. 093, Z = 4. 092, P <0. 001, P =0. 002, and P <0. 001). WBC (odds ratio [OR]= 28. 543, 95% confidence interval [CI]:1. 285 - 634. 113, P <0. 05), PTA(OR =0. 194, 95% CI:0. 045 - 0. 835, P < 0. 05), TBil (OR =2. 197, 95% CI:1. 004 -4. 810, P <0. 05), Alb (OR = 0.448, 95%CI:0.209 -0.961, P <0.05), and Child - Pugh class (OR = 5. 164, 95% CI:1. 307 - 20. 406, P < 0. 05)were independent risk factors for hemostatic failure. Conclusion WBC, PTA, TBil, Alb, and Child - Pugh class are independent risk factors for failure in emergency EIS combined with sequential HI in the treatment of EGVB with PVE, and adequate preoperative evaluation and correction may help to improve the success rate of hemostasis. [ABSTRACT FROM AUTHOR]

BACKGROUND: The use of tourniquets during knee replacements has received widespread attention and controversy in recent years. Recently, some scholars have proposed an optimized application plan of tourniquet during operation, which is conducive to speeding up postoperative recovery of patients. OBJECTIVE: To observe the clinical effect of tranexamic acid combined with tourniquet optimization program during total knee arthroplasty. METHODS: Sixty patients with knee osteoarthritis who were admitted to the Traditional Chinese Medicine Hospital of Meishan City from March 2018 to December 2019 were included, including 20 males and 40 females. They were divided into two groups using random number table method (n=30 per group). The observation group received total knee arthroplasty, and a tourniquet was used from implantation of the prosthesis to bone cement hardening (optimization of the tourniquet). The control group received total knee arthroplasty, and the tourniquet was used throughout the treatment. The dosage and method of tranexamic acid in the two groups were the same. Serum hemoglobin, leukocytes, and C-reactive protein levels were detected at 1, 3, and 7 days postoperatively. Visual analogue scale scores were used to assess pain at 1, 3, 7 and 1 month postoperatively. At 3, 7 days and 1 month, the HSS score was used to assess knee function. The trial was approved by the ethics committee of Traditional Chinese Medicine Hospital of Meishan City. RESULTS AND CONCLUSION: (1) The hemoglobin value of the observation group at 1 day was lower than that of the control group (P < 0.05), and there was no significant difference between the two groups at other time points (P > 0.05). (2) Leukocyte count was lower in the observation group than that of the control group at 3 and 7 days (P < 0.05), and there was no significant difference between the two groups at 1 day after operation (P > 0.05). (3) C-reactive protein level was lower at 1 and 3 days after operation in the observation group than in the control group (P < 0.05), and there was no significant difference between the two groups at 7 days after the operation. (4) The visual analogue scale score at 3 days after surgery in the observation group was lower than that in the control group (P < 0.05), and there was no significant difference at the other two time points between the two groups (P > 0.05). (5) There was no significant difference in HSS scores between the two groups at various time points (P > 0.05). (6) The results showed that the optimal use of tranexamic acid combined with tourniquet can relieve pain and inflammation levels after total knee arthroplasty, which is of great significance for early recovery of the patients. [ABSTRACT FROM AUTHOR]

BACKGROUND: Perioperative blood loss in total knee arthroplasty can affect the quick recovery of patients. Many studies have proved that tranexamic acid can reduce perioperative blood loss in total knee arthroplasty, but there is still controversy and no unified view. OBJECTIVE: To investigate the effect of pulse irrigation combined with topical use of tranexamic acid on perioperative blood loss, inflammatory response and complications in total knee arthroplasty. METHODS: Totally 63 patients with unilateral knee osteoarthritis including 19 males and 44 females, aged 60 to 75 years, who were treated in the Huaian First Hospital Affiliated to Nanjing Medical University from August 2018 to December 2019, were selected. The patients were randomly divided into two groups according to the envelope balloting method. In the experimental group, 32 patients received intraoperative pulse irrigation combined with topical use of tranexamic acid in the total knee arthroplasty. In the control group, 31 patients received conventional irrigation combined with topical use of tranexamic acid in the total knee arthroplasty. Total perioperative blood loss and hidden blood loss were calculated, and the number of transfusions and blood transfusion volume were recorded. Serum inflammatory factors and coagulation function were detected 1 and 7 days postoperatively. Color ultrasonography was performed to check deep venous thrombosis in the lower extremities on day 7 after surgery. The research plan was approved by the Ethics Committee of Huaian First Hospital Affiliated to Nanjing Medical University. RESULTS AND CONCLUSION: (1) Total perioperative blood loss, hidden blood loss and transfusion rate of the experimental group were lower than those of the control group (P < 0.05). (2) At 1 and 7 days after the operation, c-reactive protein, tumor necrosis factor-α and interleukin-6 in the experimental group were lower than those in the control group (P < 0.05). (3) There was no significant difference in prothrombin time, activated partial thrombin time and international standardized ratio between the two groups (P > 0.05). (4) There was no deep vein thrombosis in the two groups. (5) The results have shown that compared with conventional irrigation combined with topical use of tranexamic acid, pulse irrigation combined with topical use of tranexamic acid could significantly reduce total and hidden blood loss in the perioperative period of total knee arthroplasty, reduce the blood transfusion rate, and reduce the inflammatory response after knee arthroplasty. [ABSTRACT FROM AUTHOR]

BACKGROUND: At present, there is no consensus and guideline for balanced hemostasis and anticoagulation in elderly patients with intertrochanteric fractures. There are few related literatures on the perioperative hemostasis and anticoagulation management of tranexamic acid combined with rivaroxaban in elderly patients with intertrochanteric fractures. OBJECTIVE: To investigate the effects of tranexamic acid combined with rivaroxaban on perioperative hemorrhage, blood transfusion, postoperative venous thrombosis in elderly patients with intertrochanteric fractures. METHODS: Sixty elderly patients with intertrochanteric fractures were enrolled and scheduled to undergo proximal femoral nail anti-rotation surgery. All patients received rivaroxaban 10 mg/d anticoagulant until 24 hours before operation. All patients were divided into two groups. Patients in the test group were intravenously injected with 1.0 g of tranexamic acid. Patients in the control group were intravenously injected with the same volume of glucose solution. Surgical blood loss, blood transfusion, and venous thrombosis prior to discharge were compared in the two groups. RESULTS AND CONCLUSION: (1) The blood loss in the test group was significantly lower than that in the control group (P < 0.05). There was no significant difference in venous thrombosis before discharge between the two groups. (2) Three patients in the test group received blood transfusions, and seven patients in the control group received blood transfusions. (3) The results confirm that tranexamic acid combined with rivaroxaban not only reduces perioperative blood loss in elderly patients with intertrochanteric fractures, but also does not increase the risk of venous thrombosis. [ABSTRACT FROM AUTHOR]

Background and objective Thoracoscopic safe and effective hemostasis is an important condition for rapid rehabilitation of thoracic surgery. Placing hemostatic materials during surgery is a commonly used method in lung cancer laparoscopic surgery. Among them, resorbable oxidized cellulose is a commonly used hemostatic material. This research aims to observe the hemostatic effect of resorbable oxidized cellulose in lung cancer surgery. Methods A retrospective analysis of 42 patients with thoracoscopic lung cancer undergoing radical surgery in the Department of Thoracic Surgery, First Affiliated Hospital of Zhejiang University School of Medicine from July 1, 2018 to December 1, 2018, and intraoperative use of regenerative oxidized cellulose to stop bleeding The clinical and pathological data were selected and the perioperative indicators were selected as the outcome events for statistical analysis. Results The mean operative time was (120.5±57.3) min. The mean intraoperative blood loss was (26.8±21.6) mL. The average postoperative drainage volume was (513.6±359.5) mL. The average postoperative chest tube indwelling time was (2.6±1.2) d. Conclusion The use of absorbable regenerated oxidized cellulose in the radical operation of thoracoscopic lung cancer has a good hemostasis effect, and is suitable for hemostasis of wounds after lymph node dissection. [ABSTRACT FROM AUTHOR]

Clinical practice has revealed that during radiofrequency ablation (RFA) treatment, patients were often informed at short notice that they needed to deliver extra medical facilities and medicine. Patients also complained that the sand pockets always slid down following treatment and needed to be supported with their hands; thus, the patients could not rest fully. Moreover, nursing staff responded that their workloads were increased by the task of informing patients to deliver extra medical facilities and medicine. Therefore, we initiated this study to resolve the problem in question. We analyzed reasons for the low integrity of RFA as follows: the RFA pretreatment preparation process was inconsistent, the health education tools were incomplete, pressurized hemostasis failed to meet patients' needs, and artificial ascites were temporarily required. According to these analyses, the project team proposed the following measures: amending the RFA schedule, establishing RFA exclusive box, and fixed support for sand bags. After implementation of these measures, the integrity of nursing staff's hepatoma RFA pretreatment preparation improved from 84.6% to 98.5%, and the patient care integrity improved from 82% to 98.7%. We expect that this project's inclusion in clinical practice can promote the completeness and quality of RFA care in patients with hepatoma. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Medical Equipment Journal is the property of Chinese Medical Equipment Journal Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To investigate the clinical effect of endoscopic variceal ligation (EVL), endoscopic injection sclerotherapy (EIS), and tissue adhesive injection in the treatment of esophagogastric junctional variceal bleeding, and to provide a reference for reasonable selection of different hemostasis methods. Methods A total of 1264 patients with liver cirrhosis and esophagogastric junctional variceal bleeding who underwent emergency gastroscopic hemostasis in Beijing Shijitan Hospital and The Fifth Medical Center of Chinese PLA General Hospital from June 2017 to June 2019 were enrolled and divided into EVL, EIS, HI groups based on the method of emergency gastroscopic hemostasis. These groups were compared in terms of success rate of operation, success rate of hemostasis, early rebleeding rate, and postoperative complications. The patients were also divided into groups based on bleeding site, and the success rates of different hemostasis methods at different sites were compared. An analysis of variance was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. Results The success rate of EIS and tissue adhesive injection was significantly higher than that of EVL, and the success rate of EIS was significantly higher than that of tissue adhesive injection (χ2=75.01, P＜0.05). Tissue adhesive injection had a significantly higher success rate of hemostasis than EVL and EIS (χ2=9.885, P＜0.05). There was no significant difference in early rebleeding rate between groups (χ2=0.29，P=0.865). The patients undergoing EVL had a significantly higher incidence rate of aspiration and pneumonia than those undergoing EIS or tissue adhesive injection (χ2=19.08, P＜0.05); the patients undergoing tissue adhesive injection had a significantly higher proportion of patients with postoperative pyrexia than those undergoing EVL or EIS (χ2=23.94, P＜0.05); the patients undergoing EVL or tissue adhesive injection had a significantly higher incidence rate of postoperative retrosternal discomfort than those undergoing EIS (χ2=19.56, P＜0.05). EIS and EVL had a high success rate of hemostasis for the bleeding sites at 1-5 cm above the esophagogastric junction (EGJ); EIS and tissue adhesive injection had a similar success rate of hemostasis for the bleeding sites from 1 cm above the EGJ to 2 cm below the EGJ; tissue adhesive injection had a high success rate of hemostasis for the bleeding sites at 2-5 cm below the EGJ. Conclusion EVL, EIS, and tissue adhesive injection are effective methods for the treatment of esophagogastric junctional variceal bleeding, and the selection of hemostasis method based on the location of bleeding site can improve the outcome of hemostasis. [ABSTRACT FROM AUTHOR]

Background and objective Da Vinci robotic system is currently widely used in thoracic surgery. The ports employment and procedures vary in different medical center in China. Usually, a small incision was used for assistant. Methods Based on clinical practice, we summarized domestic and foreign experience, combined with the characteristics of the Chinese body anatomy, employ portal technique and artificial pneumothorax, summarized a set of simplified and easier surgical method. Results Port-only artificial pneumothorax robot-assisted lobectomy has further improvement in anatomical safety, hemostatic effect and aesthetic appearance of the wound. Conclusion This study optimizes the procedure of port-only artificial pneumothorax robot-assisted lobectomy in order to serve lung cancer patients better. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Medical Equipment Journal is the property of Chinese Medical Equipment Journal Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Medical Equipment Journal is the property of Chinese Medical Equipment Journal Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Adhesives have emerged as an effective method for wound closure, hemostasis and tissue engineering in recent years, which not only are suitable for the adhesion of wet tissues, but also can adapt to the peristalsis and mechanical stretching of tissues and organs, especially for arteries and organize bleeding. With the further development of technology, existing adhesives can be modified through different strategies, and new materials are explored, giving new properties and uses to adhesives, such as drug delivery, temperature sensitivity, light sensitivity and so on. Nevertheless, there are many questions about the design and practical clinical application of adhesives in the future. The recent research progress of traditional adhesives and their application in hemostasis is reviewed, and the design and development ideas of future adhesives are discussed in the study.

Objective: To create a novel chitosan antibacterial hemostatic sponge (NCAHS) and to evaluate its material and biological properties., Methods: Chitosan, a polysaccharide, was used as the sponge substrate and different proportions of sodium tripolyphosphate (STPP), glycerol, and phenol sulfonyl ethylamine were added to prepare the sponges through the freeze-drying method. The whole-blood coagulation index (BCI) was used as the screening criterion to determine the optimal concentrations of chitosan and the other additives and the hemostatic sponges were prepared accordingly. Zein/calcium carbonate (Zein/CaCO 3 ) composite microspheres loaded with ciprofloxacin hydrochloride were prepared and added to the hemostatic sponges to obtain NCAHS. Scanning electron microscope was used to observe the microscopic morphology and porosity of the NCAHS. The water absorption rate, in vitro antibacterial susceptibility rate against Staphylococcus aureus ( S. aureus ) and Escherichia coli ( E. coli ), in vitro coagulation performance, and hemocompatibility of NCAHS were examined. The coagulation performance of NCAHS was evaluated by using rabbit liver injury and rabbit auricular artery hemorrhageear models and commercial hemostatic sponge (CHS) was used as a control. The in vivo biocompatibility, including such aspects as cytotoxicity, skin irritation in animals, and acute in vivo toxicity, of the NCAHS extracts was examined by using as a reference the national standards for biological evaluation of medical devices., Results: The NCAHS prepared with 1.5% chitosan ( W / V ), 0.01% STPP ( W / V ), 0% glycerol ( V / V ), 0.15% phenol-sulfonyl-ethylamine ( V / V ), Zein and CaCO 3 at the mixing ratio of 5∶1 ( W / W ), Zein at the final mass concentration of 2.5 g/L, and ethanol at the final concentration of 17.5% ( V / V ) were fine and homogeneous, possessing a honeycomb-like porous structure with a pore size of about 200 μm. The NCAHS thus prepared had the lowest BCI value. The water absorption ([2362.16±201.15] % vs. [1102.56±91.79]%) and in vitro coagulation performance (31.338% vs. 1.591%) of NCAHS were significantly better than those of CHS ( P <0.01). Tests with the in vivo auricular artery hemorrhage model ([36.00±13.42] s vs. [80.00±17.32] s) and rabbit liver bleeding model ([30.00±0] s vs. [70.00±17.32] s) showed that the hemostasis time of NCAHS was significantly shorter than that of CHS ( P <0.01). NCAHS had significant inhibitory ability against S. aureus and E. coli . In addition, NCAHS showed good in vitro and in vivo biocompatibility., Conclusion: NCAHS is a composite sponge that shows excellent antimicrobial properties, hemostatic effect, and biocompatibility. Therefore, its extensive application in clinical settings is warranted., Competing Interests: 利益冲突　所有作者均声明不存在利益冲突, (© 2024《四川大学学报（医学版）》编辑部 版权所有Copyright ©2024 Editorial Board of Journal of Sichuan University (Medical Sciences).)

To analyze the efficacy and safety of upper gastrointestinal tumor treated by endoscopic submucosal dissection (ESD) and endoscopic submucosal excavation (ESE). Clinical data of 68 hospitalized patients with upper gastrointestinal tumor who underwent ESD or ESE in our hospital from January 2017 to April 2019 were collected, such as basic diseases, the size, operation time, complete resection rate and complication. According to the Logistic regression equation analysis, the risk factors for the complications of perforation were analyzed. The tumors of 64 cases (94.12%) of patients were en-bloc resected, and the average tumor size was (16.98± 8.29 mm). Pathological results showed that high grade intraepithelial neoplasia was the most, 15 cases (22.06%) in the lesion of esophagus. The top three were gastric body, gastric fundus and gastric antrum in gastric lesions, there were 18 cases (26.47%), 16 cases (23.53%) and 12 cases (17.65%), respectively. Pathological results showed that stromal tumor was the most (36.76%). Complications occurred in 11 cases (16.18%), included 4 cases (5.88%) of delayed bleeding (all of them were treated successfully by endoscopic hemostasis therapy), and 8 patients (11.76%) with perforation (all of them were successfully treated by coagulation hemostasis and hemoclip), including 1 patient with perforation and delayed bleeding. Lesion diameter (≥ 25 mm, P=0.036) and lesion locating at the gastric fundus (P=0.015) were the independent risk factors for perforation in ESD or ESE. ESD and ESE are safe and effective technique for upper gastrointestinal tumor. However, lesion diameter and lesion locating at the gastric fundus should be paid attention as they are the risk factors for perforation. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Medical Equipment Journal is the property of Chinese Medical Equipment Journal Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Medical Equipment Journal is the property of Chinese Medical Equipment Journal Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: Recombinant collagen has good hydrophilicity and biocompatibility, but it has the disadvantages of strong solubility and low mechanical strength. Chemical crosslinking can significantly improve the toughness, mechanical strength and degradation resistance of the material. OBJECTIVE: To prepare recombinant collagen sponge and to evaluate its physicochemical properties and safety. METHODS: The recombinant collagen was obtained via microbial fermentation and cross-linked with glutaraldehyde. The porous recombinant collagen sponge was finally obtained by freeze-drying in the mold. The water absorption, porosity and crosslinking agent residual of the recombinant collagen sponge were detected. The surface morphology of the recombinant collagen sponge before and after cross-linking was observed by scanning electron microscope. The changes in recombinant collagen structures before and after cross-linking were compared by infrared spectrometer. L929 cells were cultured with cross-linked recombinant collagen sponge extract. At 68 hours after culture, the relative proliferation rate of the cells was detected by MTT, and the cytotoxicity of cross-linked recombinant collagen sponge was evaluated. RESULTS AND CONCLUSION: (1) The water absorption of the cross-linked collagen sponge was (2 903.83±47.90)% and the average porosity was over 85%. (2) Under the scanning electron microscope, the pores of the collagen sponge were honeycomb and dense before cross-linking. After cross-linking, the pores of the collagen sponge were large and bridged bond linkage of laminar layer structure could be seen, and also the large folds could be seen in the longitudinal direction. (3) There was no obvious change in the characteristic chemical structure of the recombinant collagen sponge after cross-linking. (4) The relative proliferation rate of L929 cells was 84% after culture in cross-linked recombinant collagen sponge extract, and the cytotoxicity was level 1, indicating the biological safety was good. To conclude, the recombinant collagen sponge with glutaraldehyde cross-linking shows stable physicochemical properties and good biocompatibility. [ABSTRACT FROM AUTHOR]

Abstract BACKGROUND: As a new type of biomaterial, self-assembling peptide hydrogel is widely used in tissue engineering, drug release, hemostasis and antibacterial agents. OBJECTIVE: To summarize the hemostatic effect and mechanism of self-assembling peptide hydrogel materials in different bleeding models. METHODS: Using “self-assembling peptide, hydrogel, hemostasis, trauma” as the key words in Chinese and English, respectively, we retrieved the related literatures published from 2000 to 2018 in PubMed, CNKI, WanFang databases. RESULTS AND CONCLUSION: Self-assembling peptide materials are characterized as programmability, good viscoelasticity, high biocompatibility and low immunogenicity. The short peptides can self-assemble into nanofiber hydrogels and exhibit good biocompatibility. In different surgical wounds, hydrogels can form physical barriers to exert hemostasis without interacting with the clotting cascade or being coagulated, which can quickly and effectively control bleeding without harm to surrounding tissues or cells. Reasonable use of short peptides that have antibacterial and drug sustained-release properties can ensure rapid hemostatic effect, and meanwhile improve wound microenvironment. Self-assembling peptide hydrogel combined with bioactive molecules to promote wound healing is one of the key research directions of self-assembling short peptide materials at this stage. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the hemostatic efficacy, safety and immunogenicity of recombinant human thrombin in the treatment of liver wounds that still ooze after conventional surgical hemostasis. Methods: A multicenter, stratified randomized, double-blind, placebo-controlled phase Ⅲ trial with a planned enrollment of 510 subjects at 33 centers, with a 2∶1 randomization to the thrombin group versus the placebo group. An interim analysis will be conducted after approximately 70% of the subjects have completed the observation period. The primary efficacy endpoint was the rate of hemostasis within 6 minutes at the point of bleeding that could be evaluated. Safety analysis was performed one month after surgery, and the positive rates of anti-drug antibody (ADA) and neutralizing antibody were evaluated. Results: At the interim analysis, a total of 348 subjects had been randomized and received the study drug (215 were male and 133 were female). They were aged 19-69 (52.9±10.9)years. Among them, 232 were in the thrombin group and 116 were in the placebo group, with balanced and comparable demographics and baseline characteristics between the two groups. The hemostasis rate at 6 minutes was 71.6% (95% CI :65.75%-77.36%) in the thrombin group and 44.0% (95% CI : 34.93%-53.00%) in the placebo group, respectively ( P <0.001). No grade≥3 drug-related adverse events and no drug-related deaths were reported from the study.No recombinant human thrombin-induced immunologically-enhanced ADA or immunologically-induced ADA was detected after topical use in subjects. Conclusion: Recombinant human thrombin has shown significant hemostatic efficacy and good safety in controlling bleeding during liver resection surgery, while also demonstrating low immunogenicity characteristics.

Objective: To investigate the effect of "U" suture hemostasis on the amount of bleeding in cesarean section of placenta previa patients. Methods: 96 cases of patients undergoing placenta previa cesarean section maternal admitted from September 2015 to September 2017 in our hospital were selected as the research materials and randomly assigned to two groups, with 48 cases in two groups. Both groups of patients were given the routine hemostatic treatment, the control group was given "8" suture hemostasis, the observation group was given "U" suture hemostasis, the index and hemostatic effect were compared between two groups. Results: The operation time, hemostasis time, and intraoperative blood loss of observation group were all significantly less(shorter) than those of the control group(P<0.05), the thrombin time(TT), plasma thrombin reduction time(PT), D-dimer(DD), platelet(PLT), and activated partial clotting activase time(APTT) were significantly lower than those of the control group(P<0.05), the levels of hemoglobin(HGB) and fibrinogen(FIB) were significantly higher than those of the control group(P<0.05), the effective rate of hemostasis[97.92%(47/48)] was significantly higher than that in the control group[(85.42%(41/48)](P<0.05), the time of ambulation and hospitalization were significantly shorter than those of the control group(P <0.05). Conclusion: Implementation of "U" suture hemostasis has the advantages of simple operation in the rapid hemostasis of placenta previa cesarean section, it could reduce the amount of bleeding and ensure maternal health with high safety. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of microfibrillar collagen hemostat(Avitene) in endoscopic adenoidectomy.Methods: Fifty eight patients treated with endoscopic adenoidectomy were randomly divided into group A(compression and Avitene),group B(compression and electrocautery) and group C(only compression). The operation time, hemostasis time, degree of bleeding,difficulty of hemostasis, pain, diet time and surgical complications were compared among three groups. Results: No significant difference was found in the degree of bleeding among three groups(P>0.05). The Operation time, hemostasis time and difficulty of hemostasis in group A were significantly lower than those in group B and group C(P <0.05). The postoprative pain and diet revovery time of group A were lower than those of group B(P <0.05). No surgical complications, including postoperative hemorrhage, infection or aspiration occurred in either group. Conclusions: The application of microfibrillar collagen hemostat in endoscopic adenoidectomy proved to be rapid, effective, simple and safe. [ABSTRACT FROM AUTHOR]

Liver diseases are associated with complex abnormalities in the coagulation system as the liver is involved in the synthesis of various coagulation-related proteins. Laboratory and clinical evidence suggests that patients with liver disease may achieve a state of rebalanced hemostasis, but such balance is relatively unstable, and thus bleeding and thrombosis events are observed in clinical practice. Patients with acute or chronic liver diseases might be admitted to the intensive care unit (ICU) due to serious complications such as bleeding and thrombosis. Gastrointestinal bleeding, systemic or local thrombosis, and coagulation events in extracorporeal circulation are common complications observed in patients with liver disease in the ICU. An individualized management plan of thromboprophylaxis and a wait-and-see policy for limited blood transfusion are reasonable for patients with liver disease. [ABSTRACT FROM AUTHOR]

BACKGROUND: When traumatic bleeding happens in the battlefield and remote areas, hemostatic dressings as an assisted hemostasis can provide a good hemostatic effect when the traditional method is failure to stop bleeding. OBJECTIVE: To analyze the characteristics, components, side effects and hemostatic mechanism of hemostatic dressings, in order to explore a safe and effective hemostatic dressing for prehospital or emergent trauma care. METHODS: PubMed, Embase and CNKI were retrieved using the MeSH words of “hemorrhage, wounds, injuries, hemostasis” in English and the keywords of “hemorrhage, blood loss, injuries, trauma, war, battle, hemostasis” in English and “hemostasis, bleeding, hemostatic agent, hemostatic dressing, wound, prehospital” in Chinese. RESULTS AND CONCLUSION: Hemostatic dressings are classified into concentrated coagulation factors, tissue adhesives and supplementary procoagulant factors according to the mechanism of action. These dressings have been greatly improved in the hemostatic effect and avoiding side effects, several of which have won FDA approval and applied on the battlefield. Up to now, there is still no ideal hemostatic dressing. Further investigations are required to determine the hemostatic effect and potential adverse reactions of the existing hemostatic dressings. More efforts will be made to discover new and safe hemostatic dressings. [ABSTRACT FROM AUTHOR]

BACKGROUND: Chitosan is a natural hemostatic material, but its hemostatic effect is limited and needs to be improved. Introducing alkyl groups into chitosan can modify its coagulation property. However, the coagulation mechanism of short alkyl groups that are grafted on chitosan powder is unclear until now. OBJECTIVE: To study the cytotoxicity and coagulation property of the prepared N-hexane chitosan. METHODS: N-hexane chitosan was prepared by reductive reaction and characterized by Fourier transform infrared spectroscopy and elemental analysis. Cytotoxicity of N-hexane chitosan was tested by MTT and fluorescence microscopy. Whole blood coagulation time, rheological properties and blood plasma coagulation time were evaluated for its coagulation effects. RESULTS AND CONCLUSION: (1) A series of N-hexane chitosans with substitution degree of 8.67%, 18.06%, and 32.88% were synthesized successfully. (2) MTT results showed that the toxicity of N-hexane chitosan was graded 0 and 1. Fluorescence staining results showed that L929 cells grew well on the materials and dead cells were scarcely visible, indicating the low toxicity of the materials. (3) N-hexane chitosan could promote blood clotting, and its blood coagulation efficiency was increased with its substitution degree. No significant difference was found in activated partial thromboplastin time, prothrombin time and thrombin time of N-hexane chitosans with different substitution degrees. N-hexane chitosan could not promote activation of clotting factors. Its mechanism for accelerating coagulation needs in-depth investigations. N-hexane chitosan, compared with pure chitosan, shows better clotting effect, and this effect is enhanced with the increasing of the substitution degree. [ABSTRACT FROM AUTHOR]