Feasibility of an internet-based HIV testing service: anonymous urine collection from men who have sex with men

A large proportion of people who are HIV positive do not know their serostatus because facility-based provider-initiated HIV testing and counseling, and voluntary counseling and testing, have not been efficiently implemented in China. Therefore, a new HIV testing strategy must be developed to improve testing services so that more HIV infections can be detected earlier. In this study, we established an anonymous internet-aided urine-based HIV testing service for men who have sex with men (MSM) from 1 April 2016 to 20 January 2017. In total, 3092 urine sample collection packs were distributed by grassroots organizations to MSM; 1977 (69.3%) packs were mailed back to the laboratory; and 1911 (96.7%) eligible samples were tested for HIV antibody. The rate of HIV antibody positivity was 7.1% (135/1901), excluding 10 previously-identified HIV infections. Of those tested, 65.4% (1243/1901) participants obtained their results from our website, 94 (69.6%) of 135 newly-identified urine HIV antibody-positive participants were contacted by CDC staff, and 61.7% (58/94) reported undergoing blood HIV antibody confirmation testing after learning of their urine HIV antibody test results. Of those who were tested for venous HIV antibody, 84.5% (49/58) reported being confirmed HIV antibody positive. Thirty-six of the newly diagnosed participants were successfully referred to a hospital to receive antiretroviral therapy. The rate of confirmed HIV antibody positivity was estimated to be 72.8-89.2 times of that of routine HIV antibody testing. In conclusion, this approach offers an alternative efficient HIV testing strategy to identify HIV positive persons in vulnerable populations.

Therapeutic Values of Human Urinary Kallidinogenase on Cerebrovascular Diseases

The term “tissue kallikrein” is used to describe a group of serine proteases shared considerable sequence homology and colocalize in the same chromosomal locus 19q13. 2–q13.4. It has been widely discovered in various tissues and has been proved to be involved in kinds of pathophysiological processes, such as inhibiting oxidative stress, inflammation, apoptosis, fibrosis and promoting angiogenesis, and neurogenesis. Human Urinary Kallidinogenase (HUK) extracted from human urine is a member of tissue kallikrein which could convert kininogen to kinin and hence improve the plasma kinin level. Medical value of HUK has been widely investigated in China, especially on acute ischemic stroke. In this review, we will summarize the therapeutic values of Human Urinary Kallidinogenase on acute ischemic stroke and its potential mechanisms.

Scaled SFS method for Lambertian surface 3D measurement under point source lighting

A Lambertian surface is a kind of very important assumption in shape from shading (SFS), which is widely used in many measurement cases. In this paper, a novel scaled SFS method is developed to measure the shape of a Lambertian surface with dimensions. In which, a more accurate light source model is investigated under the illumination of a simple point light source, the relationship between surface depth map and the recorded image grayscale is established by introducing the camera matrix into the model. Together with the constraints of brightness, smoothness and integrability, the surface shape with dimensions can be obtained by analyzing only one image using the scaled SFS method. The algorithm simulations show a perfect matching between the simulated structures and the results, the rebuilding root mean square error (RMSE) is below 0.6mm. Further experiment is performed by measuring a PVC tube internal surface, the overall measurement error lies below 2%.

Carotenoid supplementation and retinoic acid in immunoglobulin A regulation of the gut microbiota dysbiosis

Dysbiosis, a broad spectrum of imbalance of the gut microbiota, may progress to microbiota dysfunction. Dysbiosis is linked to some human diseases, such as inflammation-related disorders and metabolic syndromes. However, the underlying mechanisms of the pathogenesis of dysbiosis remain elusive. Recent findings suggest that the microbiome and gut immune responses, like immunoglobulin A production, play critical roles in the gut homeostasis and function, and the progression of dysbiosis. In the past two decades, much progress has been made in better understanding of production of immunoglobulin A and its association with commensal microbiota. The present minireview summarizes the recent findings in the gut microbiota dysbiosis and dysfunction of immunoglobulin A induced by the imbalance of pathogenic bacteria and commensal microbiota. We also propose the potentials of dietary carotenoids, such as β-carotene and astaxanthin, in the improvement of the gut immune system maturation and immunoglobulin A production, and the consequent promotion of the gut health. Impact statement The concept of carotenoid metabolism in the gut health has not been well established in the literature. Here, we review and discuss the roles of retinoic acid and carotenoids, including pro-vitamin A carotenoids and xanthophylls in the maturation of the gut immune system and IgA production. This is the first review article about the carotenoid supplements and the metabolites in the regulation of the gut microbiome. We hope this review would provide a new direction for the management of the gut microbiota dysbiosis by application of bioactive carotenoids and the metabolites.

Long-term risk of diabetes in women at varying durations after gestational diabetes: a systematic review and meta-analysis with more than 2 million women

This study aims to investigate the impact of gestational diabetes mellitus (GDM) on the long-term risks of diabetes in women with prior GDM, including the effect at different time periods after GDM. We searched PubMed and other databases to retrieve articles which were published prior to February 28, 2017. Cohort studies which evaluated the risk and time of onset of diabetes postpartum in women with and without GDM were included. Meta-analysis with random effects models was used to obtain pooled relative risks and 95% confidence intervals for the risk of diabetes. Subgroup analyses were performed to check for different effect sizes as well as consistency across groups. Multivariable logistic regression was used to adjust for confounders. Thirty cohort studies with 2,626,905 pregnant women were included. Women with prior GDM had 7.76-fold (95% confidence intervals: 5.10-11.81) unadjusted pooled risk of diabetes as compared with women without GDM, whilst the adjusted risk was 17.92-fold (16.96-18.94). The adjusted ORs of GDM for diabetes among women at <3, ≥3 - <6 and ≥6 - <10 years after GDM were 5.37 (3.51-9.34), 16.55 (16.08-17.04) and 8.20 (4.53-14.86), respectively. Women with prior GDM had substantially increased risk of diabetes, with the risk highest during the 3-6 years after GDM.

Treatment of Human Urinary Kallidinogenase Combined with Maixuekang Capsule Promotes Good Functional Outcome in Ischemic Stroke

Aims: To evaluate the clinical efficacy of Human Urinary Kallidinogenase (HUK) and Maixuekang capsule in the treatment of acute ischemic stroke (AIS) patients.

Methods: In this study, from January 2016 to July 2016, 60 patients with acute ischemic stroke were enrolled and 56 patients with complete information of whom 21 patients received HUK+ basic treatment (HUK group), 16 patients received HUK+ Maixuekang capsule + basic treatment (HUK+ Maixuekang group), 19 patients received basic treatment (control group). 0.15 PNA unit of HUK injection plus 100 ml saline in intravenous infusion was performed in the HUK group and HUK+ Maixuekang group, with once a day for 14 consecutive days. 0.75 g Maixuekang capsules were taken in HUK+ Maixuekang group, with three times a day for 14 consecutive days. The National Institutes of Health Stroke Scale (NIHSS) scores in three groups were analyzed 7 days after treatment. The modified Rankin Scale (mRS) scores in three groups were analyzed 12 month after the treatment.

Results: No difference was found in the NIHSS scores, age, gender, and comorbidities between three groups before treatment (p > 0.05). Seven days after treatment, the NIHSS scores in the HUK group and HUK+ Maixuekang group were significantly decreased than before (p _HUK = 0.001, p _{HUK+Maixuekang} < 0.001), and lower than that in the control group (p _HUK = 0.032; p _{HUK+Maixuekang} < 0.001). Twelve months after treatment, good functional outcome rate (12 month mRS score ≤ 2) in the HUK group and HUK+ Maixuekang group was significantly higher than that in the control group (p _HUK = 0.049, p _{HUK+Maixuekang} = 0.032).

Conclusion: The treatment of HUK or HUK combined with Maixuekang capsule can effectively improve the neurological function and promote long-term recovery for AIS patients.

[Development of Biliary Contrast Agents Remote Pushing Device]

A biliary contrast agents pushing device, including a syringe pushing system and a remote controller is introduced. The syringe pushing system comprises an injector card slot, a support platform and an injection bolus fader. A 20 mL syringe can be fitted on the syringe pushing system and kept with the ground about 30 degree. This system can perform air bubble pumping back and contrast agents bolus injection as well as speed adjustment. Remote controller is an infrared remote control which can start and stop the syringe pushing system. With this device, the remote controlled cholangiography technology can be achieved, which can not only protect doctors from X-ray radiation but also improve the traditional T-tube cholangiography and the contrast effect, reduce postoperative complications in patients as well. The application of this device will improve the current diagnosis and treatment system, the device will benefit the majority of doctors and patients.

Effect of ribonucleotide reductase M1 expression on overall survival in patients with pancreatic cancer receiving gemcitabine chemotherapy: A literature-based meta-analysis

WHAT IS KNOWN AND OBJECTIVE

The prognostic value of ribonucleotide reductase M1 (RRM1) in patients with pancreatic cancer receiving gemcitabine chemotherapy has been evaluated in several studies. However, the conclusions remain controversial.

METHODS

By searching the PubMed and Embase databases, we conducted a meta-analysis to evaluate the prognostic significance of RRM1 expression in patients with pancreatic cancer receiving gemcitabine chemotherapy. Studies were pooled, and the hazard ratio (HR) and its corresponding 95% confidence interval (CI) were calculated.

RESULTS

Nine relevant articles were included for this meta-analysis study. Our results revealed that the high-RRM1 expression patients had significantly poorer overall survival (HR = 1.70, 95% CI = 1.33-2.16, P_{heterogeneity}  = .061, I²  = 44.8%) and disease-free survival (HR = 1.84, 95% CI = 1.56-2.18, P_{heterogeneity}  = .669, I²  = 0%) than the low-RRM1 expression patients. Furthermore, a statistically significant association between RRM1 expression and OS was found among both Japanese (HR = 1.80, 95% CI = 1.36-2.37, P_{heterogeneity}  = .843, I²  = 0%) and American patients (HR = 1.76, 95% CI = 1.60-1.94, P_{heterogeneity}  = .439, I²  = 0%).

WHAT IS NEW AND CONCLUSION

In conclusion, the expression of RRM1 can be considered a predictor of poor survival in patients with pancreatic cancer receiving gemcitabine chemotherapy. RRM1 expression assessment could provide more detailed information for patients with pancreatic cancer and could be used to optimize therapeutic schemes.

[Development of Diagrammatic Recording System for Choledochoscope and Its Clinical Application]

OBJECTIVES

To develop a diagrammatic recording system for choledochoscopy and evaluate the system with clinical application.

METHODS

To match the real-time image and procedure illustration during choledochoscopy examination, we combined video-image capture and speech recognition technology to quickly generate personalized choledochoscopy images and texts records. The new system could be used in sharing territorial electronic medical records, telecommuting, scientific research and education, et al.

RESULTS

In the clinical application of 32 patients, the choledochoscopy diagrammatic recording system could significantly improve the surgeons' working efficiency and patients' satisfaction. It could also meet the design requirement of remote information interaction.

CONCLUSIONS

The choledochoscopy diagrammatic recording system which is recommended could elevate the quality of medical service and promote academic exchange and training.

Targeted Metabolomics Reveals Abnormal Hepatic Energy Metabolism by Depletion of β-Carotene Oxygenase 2 in Mice

β-carotene oxygenase 2 (BCO2) is a carotenoid cleavage enzyme located in the inner mitochondrial membrane. Ablation of BCO2 impairs mitochondrial function leading to oxidative stress. Herein, we performed a targeted metabolomics study using ultrahigh performance liquid chromatography-tandem mass spectroscopy and gas chromatography-mass spectroscopy to discriminate global metabolites profiles in liver samples from six-week-old male BCO2 systemic knockout (KO), heterozygous (Het), and wild type (WT) mice fed a chow diet. Principal components analysis revealed distinct differences in metabolites in the livers of KO mice, compared to WT and Het mice. However, no marked difference was found in the metabolites of the Het mouse liver compared to the WT. We then conducted random forest analysis to classify the potential biomarkers to further elucidate the different metabolomics profiles. We found that systemic ablation of BCO2 led to perturbations in mitochondrial function and metabolism in the TCA cycle, amino acids, carnitine, lipids, and bile acids. In conclusion, BCO2 is essential to macronutrient and mitochondrial metabolism in the livers of mice. The ablation of BCO2 causes dysfunctional mitochondria and altered energy metabolism, which further leads to systemic oxidative stress and inflammation. A single functional copy of BCO2 largely rescues the hepatic metabolic homeostasis in mice.

Integrated Graphene Oxide Purification-Lateral Flow Test Strips (iGOP-LFTS) for Direct Detection of PCR Products with Enhanced Sensitivity and Specificity

An integrated graphene oxide purification-lateral flow test strip (iGOP-LFTS) was developed for on-strip purifying and visually detecting polymerase chain reaction (PCR) products with an improved sensitivity as well as a more stringent specificity. PCR products amplified with a pair of biotin- and digoxin-labeled primers were directly pipetted onto GO pads, on which graphene oxide selectively adsorbed residual primers and primer-dimers with the aid of a running buffer containing MgCl₂ and Tween 20. By stacking up three GO pads to increase the surface area for adsorption, 83.4% of double-stranded DNA with a length of 30 bp and 98.6% of 20-nt primers could be removed from a 10-μL DNA mixture. Since no primers interfered with detection, the increase of the sample loading volume from 5 to 20 μL could improve the signal-to-noise ratio of the test line 1.6 fold using the iGOP-LFTS while no changes were observed using the conventional LFTS. The limit of detection of the iGOP-LFTS was determined to be 30 copies of bacteriophage λ-DNA with naked eyes and this limit could be further decreased to 3 copies by loading 20 μL of the sample, which corresponded to a 1000-fold improvement compared to that of the LFTS detected by naked eyes. When the ImageJ analysis was employed, a 100-fold decrease of the detection limit can be obtained. In addition, due to the removal of the primer-dimers, the dim test line observed in the negative control of the LFTS was eliminated using the iGOP-LFTS. A mock clinical specimen spiked with defective HIV-1 (human immunodeficiency virus) viruses was successfully analyzed using a two-step reverse transcription-PCR with 30 amplification cycles followed by the iGOP-LFTS detection. These significant improvements were achieved without introducing any additional hands-on operations and instrumentations.

Human Urinary kallidinogenase promotes good recovery in ischemic stroke patients with level 3 hypertension

AIM

To evaluate the clinical efficacy of Human Urinary kallidinogenase (HUK) in the treatment of acute ischemic stroke (AIS) patients with level 3 hypertension.

METHODS

In this retrospective study, from January 2015 to June 2016, 150 consecutive AIS patients were registered in our database. Among them, 47 with level 3 hypertension received either HUK treatment (HUK group, 22 cases) or basic treatment (control group, 25 cases). Basic treatment was administrated on all patients. 0.15 PNA unit of HUK injection plus 100 ml saline in intravenous infusion was performed in the HUK group, with once a day for 14 consecutive days. The modified Rankin Scale (mRS) scores in two groups were analyzed 3 months after the treatment.

RESULTS

No difference was found in the NIHSS scores, age, gender, and comorbidities between two groups before treatment (p > .05). While after treatment, 3-month mRS score was significantly lower in the HUK group (2.1 ± 1.4 vs. 3.1 ± 1.3, p = .012) and good recovery rate (3-month mRS score ≤2) in the HUK group was significantly higher than that in the control group (p < .05).

CONCLUSION

HUK is able to promote long-term recovery for AIS patients with level 3 hypertension remarkably.

Dysfunction of the WT1-MEG3 signaling promotes AML leukemogenesis via p53-dependent and -independent pathways

Long non-coding RNAs (lncRNAs) play a pivotal role in tumorigenesis, exemplified by the recent finding that lncRNA maternally expressed gene 3 (MEG3) inhibits tumor growth in a p53-dependent manner. Acute myeloid leukemia (AML) is the most common malignant myeloid disorder in adults, and TP53 mutations or loss are frequently detected in patients with therapy-related AML or AML with complex karyotype. Here, we reveal that MEG3 is significantly downregulated in AML and suppresses leukemogenesis not only in a p53-dependent, but also a p53-independent manner. In addition, MEG3 is proven to be transcriptionally activated by Wilms’ tumor 1 (WT1), dysregulation of which by epigenetic silencing or mutations is causally involved in AML. Therefore MEG3 is identified as a novel target of the WT1 molecule. Ten–eleven translocation-2 (TET2) mutations frequently occur in AML and significantly promote leukemogenesis of this disorder. In our study, TET2, acting as a cofactor of WT1, increases MEG3 expression. Taken together, our work demonstrates that TET2 dysregulated WT1-MEG3 axis significantly promotes AML leukemogenesis, paving a new avenue for diagnosis and treatment of AML patients.

[Comparison of core decompression with stem cell transplantation and tantalum rod implanting in treating stage II non-traumatic osteonecrosis of femoral head]

OBJECTIVE

To compare clinical effects of core decompression with stem cell transplantation and tantalum rod implanting in treating stage II non-traumatic osteonecrosis of femoral head.

METHODS

From March 2012 to September 2012, 45 patients(55 hips)with stage ARCO II non-traumatic osteonecrosis of femoral head were treated and divided into core decompression with stem cell transplantation group(group A) and tantalum rod implanting group(group B) according to number table. In group A, there were 23 cases(28 hips) , including 12 males and 11 females aged from 23 to 51 years old with an average of (36.87±9.52) years, the courses of disease ranged from 2 to 28 months with an average of (17.13±7.74) months, preoperative Harris score was for 35 to 70 with an average of(54.74±11.81), treated with core decompression with stem cell transplantation. In group B, there were 22 cases(27 hips), including 11 males and 11 females aged from 26 to 46 years old with an average of (35.59±7.39) years, the courses of disease ranged from 3 to 26 months with an average of(16.00±7.46) months, preoperative Harris score was for 35 to 76 with an average of (57.18±12.95), treated with core tantalum rod implanting. Operative time, blood loss, hospital stays, hospitalization expenses were observed and compared after treatment between two groups, the clinical effects were evaluated according to Harris criteria.

RESULTS

All patients were followed up from 6 to 12 months with an average of 10.8 months. There were significant difference in hospitalization expenses between two groups(P<0.05), while there was no significant statistical difference in blood loss and hospital stay (P>0.05). At the final following-up, Harris score in group A was(83.04±8.97), 6 cases obtained excellent results, 14 good, 2 good and 1 poor;while Harris score in group A was(84.41±9.94), and 9 cases obtained excellent results, 9 good, 3 good and 1 poor; there was no statistical meaning differences between two groups(P>0.05).

CONCLUSIONS

Core decompression with stem cell transplantation and tantalum rod implanting could both improve function of hip joint, while core decompression with stem cell transplantation had advantages of shorter operation time, less cost, and higher potency ratio. It is suitable for stage ARCO II non-traumatic femoral head necrosis.

[Inhibitory effect of migration-inducing gene-7-shRNA recombinant retrovirus combined with endostatin on growth and metastasis of hepatoma xenograft]

Objective: To investigate the inhibitory effect of migration-inducing gene-7(Mig-7)interfered with retrovirus-mediated RNA(shRNA)combined with recombinant human endostatin(ES)on the growth and metastasis of subcutaneous xenograft of human hepatoma cells in nude mice. Methods: Two Mig-7-mRNA oligonucleotide sequences(Mig-7-shRNA-1 and Mig-7-shRNA-2)and one sequence as a negative control(Mig-7-shRNA-N)were designed. The specific Mig-7-shRNA recombinant retrovirus expression vector plasmid was constructed and used for the transfection of human hepatoma MHCC-97H cells with high expression of Mig-7. The subcutaneous xenograft tumor model of human hepatocellular carcinoma(HCC)in nude mice was established, and according to the condition of transfection and administration, the nude mice were divided into pSIREN-M1 group, pSIREN-MN group, ES group, and pSIREN-M1+ES group. The xenograft tumor volume, mass, and metastasis were compared between groups. Immunohistochemistry was used to observe the formation of vasculogenic mimicry(VM)in xenograft tumor and the difference in tumor microvascular density(MVD), and Western blot was used to measure the expression of Mig-7 and vascular endothelial growth factor(VEGF)in each group. A one-way analysis of variance was used for comparison between groups, and the Fisher's exact test was used for comparison of continuous data between groups. Results: Compared with the pSIREN-MN group, the pSIREN-M1 group had significantly lower xenograft tumor volume, mass, and metastasis rate, Mig-7 expression, and formation of VM(P < 0.05), as well as significantly higher VEGF expression and MVD(P < 0.05). Compared with the pSIREN-MN group, the ES group had significantly lower xenograft tumor volume, mass, and metastasis rate, VEGF expression, and MVD(P < 0.05), as well as significantly higher Mig-7 expression and formation of VM(P < 0.05). Compared with the pSIREN-M1 group and the ES group, the pSIREN-M1+ES group had significantly lower xenograft tumor volume, mass, and metastasis rate, Mig-7 expression, formation of VM, VEGF expression, and MVD(P < 0.05). Conclusion: Mig-7-shRNA recombinant retrovirus combined with ES has a better inhibitory effect on the growth and metastasis of HCC xenograft tumor than Mig-7-shRNA recombinant retrovirus or ES alone. The anti-tumor angiogenesis therapy alone, which targets vascular endothelial cells in vivo, has a limited effect, since it may promote the formation of VM.

Treatment of diabetes with encapsulated pig islets: an update on current developments

The potential use of allogeneic islet transplantation in curing type 1 diabetes mellitus has been adequately demonstrated, but its large-scale application is limited by the short supply of donor islets and the need for sustained and heavy immunosuppressive therapy. Encapsulation of pig islets was therefore suggested with a view to providing a possible alternative source of islet grafts and avoiding chronic immunosuppression and associated adverse or toxic effects. Nevertheless, several vital elements should be taken into account before this therapy becomes a clinical reality, including cell sources, encapsulation approaches, and implantation sites. This paper provides a comprehensive review of xenotransplantation of encapsulated pig islets for the treatment of type 1 diabetes mellitus, including current research findings and suggestions for future studies.

Study of Individual Characteristic Abdominal Wall Thickness Based on Magnetic Anchored Surgical Instruments

Background:

Magnetic anchored surgical instruments (MASI), relying on magnetic force, can break through the limitations of the single port approach in dexterity. Individual characteristic abdominal wall thickness (ICAWT) deeply influences magnetic force that determines the safety of MASI. The purpose of this study was to research the abdominal wall characteristics in MASI applied environment to find ICAWT, and then construct an artful method to predict ICAWT, resulting in better safety and feasibility for MASI.

Methods:

For MASI, ICAWT is referred to the thickness of thickest point in the applied environment. We determined ICAWT through finding the thickest point in computed tomography scans. We also investigated the traits of abdominal wall thickness to discover the factor that can be used to predict ICAWT.

Results:

Abdominal wall at C point in the middle third lumbar vertebra plane (L3) is the thickest during chosen points. Fat layer thickness plays a more important role in abdominal wall thickness than muscle layer thickness. “BMI-ICAWT” curve was obtained based on abdominal wall thickness of C point in L3 plane, and the expression was as follow: f(x) = P1 × x² + P2 × x + P3, where P1 = 0.03916 (0.01776, 0.06056), P2 = 1.098 (0.03197, 2.164), P3 = −18.52 (−31.64, −5.412), R-square: 0.99.

Conclusions:

Abdominal wall thickness of C point at L3 could be regarded as ICAWT. BMI could be a reliable predictor of ICAWT. In the light of “BMI-ICAWT” curve, we may conveniently predict ICAWT by BMI, resulting a better safety and feasibility for MASI.

Antimicrobial activity of recombinant mature bovine neutrophil β-defensin 4 on mycobacterial infection

BACKGROUND

Previous studies have shown that human cathelicidin and defensins have effective antimicrobial activity against Mycobacterium spp.

OBJECTIVE

To investigate the antimycobacterial effect of mature bovine neutrophil β-defensin (mBNBD) 4 against Mycobacterium spp. infection for the first time.

DESIGN

mBNBD4 protein was expressed in Pichia pastoris GS115. We used immunofluorescent assay to detect whether the recombinant mBNBD4 had entered the macrophages. The antimycobacterial activity of mBNBD4 was tested through colony-forming unit (cfu) assay. Morphological changes in the cell wall of M. bovis treated with mBNBD4 were observed by scanning electron microscope.

RESULTS

mBNBD4 was expressed and successfully purified from P. pastoris with intact antimicrobial activity. The recombinant protein was able to enter Raw 264.7 macrophages and exhibited potent in vitro bactericidal activity against M. smegmatis and M. bovis. The cell wall of M. bovis was disrupted after interaction with mBNBD4. Exogenous addition of mBNBD4 to both Raw 264.7 and THP-1 derived macrophages reduced the intracellular survival of M. bovis and M. tuberculosis relative to control cells.

CONCLUSION

Our data show that mBNBD4 plays an important role in inhibiting mycobacterial growth and in controlling intracellular survival of mycobacteria. mBNBD4 could therefore an effective antimycobacterial molecule in combination with other measures.

Risk Factors for the Postoperative Transfusion of Allogeneic Blood in Orthopedics Patients With Intraoperative Blood Salvage: A Retrospective Cohort Study

The purpose of this study is to explore the risk factors affecting the postoperative transfusion of allogeneic blood in patients undergoing orthopedics surgery with intraoperative blood salvage (IBS). A retrospective study of 279 patients undergoing orthopedic surgeries with IBS from May 2013 to May 2015 was enrolled. The binary logistic regression was used to find out the risk factors associated with postoperative transfusion of allogeneic blood in orthopedics patients with IBS, and then receiver operating characteristic (ROC) curve was drawn to determine the optimal threshold of the regression model.Single factor analysis showed that age, American Society of Anesthesiologists (ASA) grade, preoperative hemoglobin, operation time, received autologous blood, the laying time of autologous blood, bleeding volume, and postoperative drainage volume had significant effects on postoperative allogeneic blood transfusion.In binary logistic regression analysis, the independent factors predicting orthopedic patients with IBS need to transfuse allogeneic blood after surgeries were age (odds ratio [OR] = 0.415, P = 0.006), ASA grade (OR = 2.393, P = 0.035), preoperative hemoglobin (OR = 0.532, P = 0.022), and postoperative drainage volume (OR = 4.279, P = 0.000). The area under ROC curve was 0.79 and the predicted accuracy rate of the model was 81.58%.After operation, the orthopedic patients with IBS still have a high allogeneic blood transfusion rate, and IBS is not a perfect blood protection method. The logistic regression model of our study provides a reliable prediction for postoperative transfusion of allogeneic blood in orthopedic patients with IBS, which have a certain reference value.