ObjectiveTo investigate the effects of intraoperative intermittent pneumatic compression (IPC) treatment on coagulation and fibrinolysis, lower extremity venous blood flow velocity, and deep venous thrombosis (DVT) in patients with gastric cancer (GC) after radical gastrectomy. MethodsThe patients with GC who underwent radical gastrectomy at Hebei Provincial People’s Hospital from July 2021 to July 2024 were retrospectively enrolled, then the patients were assigned into control group (the patients who did not receive intraoperative IPC) and study group (the patients who received intraoperative IPC), and the propensity score matching (PSM) method was used to conduct 1∶1 matching based on the basic characteristics such as age, gender, body mass index, comorbidities to ensure baseline comparability between the two groups. The incidences of postoperative DVT and lower extremity swelling, and coagulations [prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT)] and fibrinolysis [D-dimer (D-D), fibrinogen (FIB), and fibrin degradation products (FDP)], as well as lower extremity venous blood flow velocity were analyzed after PSM. The locally weighted regression was used to analyze the correlation between the coagulation and fibrinolytic functions indexes and the lower extremity venous blood flow velocity. ResultsA total of 120 patients were matched (60 cases per group). The baseline characteristics of both groups were comparable (P>0.05). The incidences of DVT on day 7 and lower extremity swelling on day 1, 3, and 7 after surgery in the study group were significantly lower than those in the control group (P<0.05). The results of repeated-measures analysis of variance showed that there were statistically significant differences in the inter-group, time-related, and group-by-time interaction effects of coagulation and fibrinolysis indexes as well as lower extrimety venous blood flow velocities (P<0.05). The impact of the time factor on coagulation and fibrinolysis indexes and lower extrimety venous blood flow velocities varied with intraoperative IPC intervention measures. After surgery, the PT, TT, APTT, and lower extrimety venous blood flow velocities in the study group first decreased and then increased as compared with those before surgery, and the decrease degree was smaller and the increase degree was larger than those in the control group. After surgery, the D-D, FIB, and FDP in the study group first increased and then decreased as compared with those before surgery, and the increase degree was smaller and the decrease degree was larger than those in the control group. Both PT and TT were significantly positively correlated with femoral vein blood flow velocity (r=0.21, P=0.042; r=0.22, P=0.040), and both also showed significant positive correlations with popliteal vein blood flow velocity (r=0.25, P＜0.001; r=0.20, P=0.032). APTT was only significantly positively correlated with popliteal vein blood flow velocity (r=0.33, P＜0.001). D-D was negatively correlated with the flow velocities of the femoral vein, external iliac vein, and popliteal vein (r=–0.23, P=0.012; r=–0.22, P=0.047; r=–0.37, P<0.001). Both FIB and FDP were negatively correlated with the flow velocity of the femoral vein (r=–0.23, P=0.036; r=–0.27, P=0.002). FIB was also negatively correlated with the flow velocity of the popliteal vein (r=–0.26, P=0.038), and FDP was negatively correlated with the flow velocity of the external iliac vein (r=–0.31, P<0.001). ConclusionBased on the results of this study, intraoperative IPC treatment could improve coagulation and fibrinolytic functions of patients with GC after surgery, and has a certain preventive effect on occurrence DVT of lower extremity.
Objective To analyze retrospectively the overall situation of medical rescue in the First Affiliated Hospital of Guangxi Medical University after the Wenchuan earthquake, so as to provide references for the emergency preparation for the disaster of earthquake. Methods Analysis was based on the data provided by the Department of Information, the Medical Record Library, the Department of Emergency, the Department of Orthopaedics and other related departments of the hospital. The software Microsoft EXCEL was used for data management, and SPSS 13.0 was used for statistical analysis. Results From May 22 to May 26, 91 cases from the disaster area had been treated in the hospital, of which 90 were from Mianyang and 1 from Chengdu. These patients included 44 males with a median age of 38 (27, 53) years old and 47 females with a median age of 51 (33, 62) years old. Most patients were sent to the hospital within the first 10 or 11 days after the earthquake, with 86.8% hospitalized after 10 days and 22.0% after 11 days. The number of outpatients reached its peak of 37.1% of all the outpatients (33 cases) within 34 days after the earthquake. The wounded were mainly admitted into the Department of Orthopaedics, with 34.81% of the patients having lower limb fracture, 18.26% having spine fracture, and 12.59% suffering pelvis fracture. Only 2 out of the 89 patients died. One death was due to 60% burning injury and 1 died of multiple catastrophic injuries. Conclusion Based on the data, it is important to develop an emergent plan for medical rescues after an earthquake disaster and to strengthen the reserve of medical supplies, personnel training, scientific field triage and the construction of information platforms.
Objective To analyze the clinical information of COVID-19 patients of Shanghai National Exhibition and Convention Center cabin hospital, and to explore the medical management strategy to provide thoughtful suggestions for other cabin hospitals and governments as valuable references. Methods The clinical data of 174 308 patients confirmed COVID-19 in Shanghai National Exhibition and Convention Center cabin hospital from April 9 to May 31, 2022 were retrospectively reviewed. There were 103 539 male and 70 769 female patients, with an average age of 41.50±15.30 years. Medical and nursing management strategy was summarized. Results Among the 174 308 patients, 71.5% (124 630 patients) were asymptomatic. The vaccination rate of patients with COVID-19 in the cabin hospital was 76.5% (133 338 patients), and the majority of none vaccinated patients were children under the age of 10 years and the elderly over the age of 60 years, the vaccination rate of whom was only 25.0% (1 322 patients) and 63.9% (13 715 patients), respectively. In addition, the proportion of mild symptom type in the patients not vaccinated was significantly higher than that in the vaccinated patients (P≤0.01). The average hospitalization time of patients in cabin hospital was 7.39±0.53 days, which was 7.01±2.12 days for patients under 60 years and 8.21±0.82 days for patients over 60 years. The hospitalization time of elderly patients was significantly longer (P≤0.01), and the hospitalization time of elderly patients at age over 60 years without vaccination was 8.94±1.71 days, which was significantly longer than the average hospitalization time and the time of elderly patients vaccinated (P≤0.01). The number of patients combined with basic diseases was 27 864 (16.0%), of which cardiovascular diseases accounted for 81.3% (22 653 patients). A total of 2 085 patients were transferred and treated in designated hospitals. Conclusion Large scale cabin hospitals are helpful to cut off the source of infection. Attention shall be paid to the sorting of admission and timely transfer to other hospital during the patients management. Most of the patients have a good prognosis after treatment. The vaccination of key population and community-based screening will be the next step of focus.