ObjectiveTo analyze the predictive value of thrombelastogram (TEG) on venous thromboembolism in elderly patients undergoing cardiac surgery.MethodsA total of 64 patients with venous thromboembolism after cardiac surgery in our hospital from March 2014 to March 2018 were selected as a pathogenesis group, including 38 males and 26 females, aged 61-73 (67.3±5.8) years. And 158 patients without venous thromboembolism who underwent cardiac surgery during the same period were selected as a control group, including 82 males and 76 females, aged 59-75 (65.9±7.1) years. Routine coagulation parameters such as plasma prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fib), D-dimer (D-D), platelet count (PLT) and various indicators of TEG were measured in two groups. The correlation analysis was performed on the obtained results, and the specificity and sensitivity of conventional coagulation indicators and TEG indicators for venous thromboembolism were analyzed and compared.ResultsThere were significant differences between the two groups in routine coagulation parameters and TEG (P<0.05). The area under the receiver operating characteristic (ROC) curve for each indicator was >0.5, which was of diagnostic significance. When the sensitivity>90%, the highest specificity value was also selected. The sensitivity and specificity of each indicator of TEG were greater than those of conventional coagulation indicators. The reaction time (R) was positively correlated with APTT in all indicators of TEG, and coagulation speed (K) was negatively correlated with Fib and PLT. Maximum thrombus intensity (MA) and Angle were positively correlated with Fib and PLT (all P<0.05). There was no correlation between TEG indicators and D-D.ConclusionThe TEG has higher predictive value for postoperative venous thromboembolism in elderly patients undergoing cardiac surgery than conventional coagulation tests. However, D-D level tests have unique diagnostic value in the diagnosis of venous thromboembolism.
Objective To discuss influence of spinal surgery on quality of life (QOL) of patients with late-period spinal metastatic tumor and to explore if spinal surgery could influence on survival time of patients or not. Methods From July 2007 to March 2009, we identified patients who were eligible for the observational study hospitalized in Changzheng Hospital, the Second Military Medical University in Shanghai, China. All eligible patients were divided into two groups depending on whether they would receive spinal surgery or not. Then, all eligible patients completed five QOL assessments using the Functional Assessment of Cancer Therapy-General (FACT-G) Questionnaire when they were diagnosed as late-period spinal metastatic tumor, after 1-month treatment, after 3-month treatment, after 6-month treatment, and after 9-month treatment. Survival time of each patient was also recorded. Results We identified 312 patients who were eligible for the study (surgery group, 147 cases; and non-surgery group, 165 cases). There was no significant difference in survival time between the two groups (χ2=3.167, P=0.075). Within 9 months, the surgery group had significantly higher physical well-being scores, emotional well-being scores, functional well-being scores and total QOL scores than the non-surgery group. Conclusion The results of this study suggest that spinal surgery can significantly improve the QOL of patients with late-period spinal metastatic tumor, but cannot prolong the survival time.
Objective To investigate the psychological stress level and its influence factors of the motor transport soldiers in Military Station C at high altitude, and provide the data basis for the proper stress management. Methods A cluster random sampling was performed on the motor transport soldiers in Military Station C. And SCL-90 were adopted to measure the psychological stress level of the motor transport soldiers while the self-made basic information questionnaire was conducted to collect the information of demographic characteristic, length of military service, driving years. Then the effect of basic information on the psychological stress level was analyzed. Results 1 692 soldiers in Military Station C were enrolled in this survey. The scores of somatization, depression, psychosis and the total score of the SCL-90 of these soldiers were higher than the norm (allP values<0.001). The scores of interpersonal relationship, depression, terror and stubborn of the only child were higher than those of non-only-child (P=0.034,P=0.039,P=0.025,P=0.002). The scores of interpersonal relationship and anxiety were positively correlated with their education levels (P=0.008,P=0.026). The compulsory servicemen had higher scores of anxiety, terror and psychosis (P<0.001,P=0.026,P=0.001) but lower scores of somatization (P<0.001) compared with the sergeants. Those who suffered from neck discomfort had higher somatization scores (P<0.001). Conclusion Some factors involved in psychological stress level of the motor transport soldiers in Military Station C are higher than the norm, suggesting that more attention should be paid to their psychological states by the army administrators and the health management department, especially the only child, new recruits, junior soldiers and those who suffers from somatization discomfort.