Correlation between pyrethroid knockdown resistance and mutation frequency of voltage-gated sodium channel and its application in Aedes aegypti management.

Aedes aegypti, the primary vector responsible for transmitting dengue fever in southern Taiwan, has developed a relatively high resistance to synthetic pyrethroids. It has evolved four amino acid substitutions in the voltage-gated sodium channel (VGSC), namely S996P, V1023G, F1565C, and D1794Y. To unveil the distribution and correlation of VGSC mutations and pyrethroid resistance among different field populations, Ae. aegypti collected from various districts in Kaohsiung and Tainan Cities underwent tests for resistance development against different pyrethroids and frequency of S996P, V1023G, F1565C, and D1794Y substitutions. The adult knockdown assay revealed a relatively high knockdown resistance in the Ae. aegypti populations from Kaohsiung and Tainan against permethrin, cypermethrin, and fenvalerate (averaging >50-fold). Conversely, less resistance was observed against α-cypermethrin, deltamethrin, λ-cyhalothrin, cyfluthrin, and etofenprox (averaging <35-fold). Using Polymerase Chain Reaction/restriction fragment length polymorphism analysis, four mutant haplotypes were identified in these field populations. Notably, the SIAVFD and SIBVFD wild haplotypes were absent. Analysis utilizing IBM SPSS Statistics 20.0 and Spearman's rank correlation coefficient indicated that Haplotype C (PIAGFD), especially P allele, frequency displayed a significant positive correlation with five Type II pyrethroid resistance, while 1023G and 1023G/G exhibited a significant association with permethrin and fevalerate resistance. Conversely, Haplotype E (SIBVCD) negatively correlated with pyrethroid resistance, particularly fenvalerate resistance (-0.776). Haplotype C and E were the most prevalent and widely distributed among the investigated field populations. This prevalence of haplotype C is likely tied to the extensive and excessive use of Type II pyrethroids for dengue control over the past three decades. Given the significant positive correlation, the best-fit lines and R2 values were established to facilitate the swift prediction of knockdown resistance levels to various pyrethroids based on VGSC mutation frequency. This predictive approach aims to guide insecticide usage and the management of pyrethroid resistance in the field populations of Ae. aegypti in Taiwan.

Early Tumor Marker Response Predicts Treatment Outcomes in Patients with Unresectable Hepatocellular Carcinoma Receiving Combined Lenvatinib, Immune Checkpoint Inhibitors, and Transcatheter Arterial Chemoembolization Therapy.

Purpose: Few reliable biomarkers for predicting the efficacy of triple therapy (lenvatinib + immune checkpoint inhibitors + transarterial chemoembolization) exist for patients with unresectable hepatocellular carcinoma (uHCC). This study explored the prognostic role of alpha-fetoprotein (AFP) and des-gamma-carboxyprothrombin (DCP) levels in patients with uHCC receiving triple therapy. Patients and Methods: This retrospective study included 93 patients with uHCC who received triple therapy at Fujian Provincial Hospital between August 2020 and November 2022. Depending on the respective baseline levels, the patients were divided into high-AFP and high-DCP groups. An early response was defined as an AFP or DCP concentration >50% less than the baseline concentration after 6 weeks of triple therapy. The primary endpoint was the objective response rate (ORR). The secondary endpoints were progression-free survival (PFS) and overall survival (OS). Results: After 6 weeks of triple therapy, 75.3% (58/77) and 78.9% (60/76) of patients in the high-AFP and high-DCP groups achieved an objective response. Early AFP and DCP responses were positively associated with ORR (high-AFP group: odds ratio [OR]: 13.542; 95% confidence interval [CI]: 3.991-45.950, p<0.001; high-DCP group: OR: 17.853; 95% CI: 4.478-71.179, p<0.001). In the high-AFP group, the 6-month, 12-month, and 18-month PFS and OS rates were higher in the AFP responders than those in the non-responders (PFS: 66.4%, 59.6%, 48.2% vs 42.3%, 19.3%, 0%, p<0.001; OS: 94.5%, 90.4%, 77.3% vs 75.6%, 66.2%, 49.6%, p=0.006). In the high-DCP group, the 6-month, 12-month, and 18-month PFS and OS rates were higher in the DCP responders than those in the non-responders (PFS: 67.4%, 57.7%, 39.0% vs 38.9%, 8.1%, 0%, p<0.001; OS: 94.7%, 94.7%, 83.3% vs 77.0%, 53.9%, 36.0%, p<0.001). Conclusion: After 6 weeks of triple therapy, an AFP or DCP reduction of >50% predicts better treatment outcomes in uHCC patients.

Identifying the Interfacial Polarization in Non-stoichiometric Lead-Free Perovskites by Defect Engineering.

Recent advances in perovskite ferroelectrics have fostered a host of exciting sensors and actuators. Defect engineering provides critical control of the performance of ferroelectric materials, especially lead-free ones. However, it remains a challenge to quantitatively study the concentration of defects due to the complexity of measurement techniques. Here, a feasible approach to analyzing the A-site defect and electron in alkali metal niobate is demonstrated. The theoretical relationships among defect concentration, conductivity, and oxygen partial pressure can be established based on the defect chemistry equilibria. The type and concentration of defects are reflected through the conductivity variation with oxygen partial pressure. As a result, the variation of defect concentration gives rise to defect-driven interfacial polarization, which further leads to distinct properties of the ceramics. e.g., abnormal dielectric behavior. Furthermore, this study also suggests a strategy to manipulate defects and charges in perovskite oxides for performance optimization.

Identification of SRY-box 30 as an age-related essential gatekeeper for male germ-cell meiosis and differentiation.

Although important factors governing the meiosis have been reported in the embryonic ovary, meiosis in postnatal testis remains poorly understood. Herein, we first report that SRY-box 30 (Sox30) is an age-related and essential regulator of meiosis in the postnatal testis. Sox30-null mice exhibited uniquely impaired testis, presenting the abnormal arrest of germ-cell differentiation and irregular Leydig cell proliferation. In aged Sox30-null mice, the observed testicular impairments were more severe. Furthermore, the germ-cell arrest occurred at the stage of meiotic zygotene spermatocytes, which is strongly associated with critical regulators of meiosis (such as Cyp26b1, Stra8 and Rec8) and sex differentiation (such as Rspo1, Foxl2, Sox9, Wnt4 and Ctnnb1). Mechanistically, Sox30 can activate Stra8 and Rec8, and inhibit Cyp26b1 and Ctnnb1 by direct binding to their promoters. A different Sox30 domain required for regulating the activity of these gene promoters, providing a "fail-safe" mechanism for Sox30 to facilitate germ-cell differentiation. Indeed, retinoic acid levels were reduced owing to increased degradation following the elevation of Cyp26b1 in Sox30-null testes. Re-expression of Sox30 in Sox30-null mice successfully restored germ-cell meiosis, differentiation and Leydig cell proliferation. Moreover, the restoration of actual fertility appeared to improve over time. Consistently, Rec8 and Stra8 were reactivated, and Cyp26b1 and Ctnnb1 were reinhibited in the restored testes. In summary, Sox30 is necessary, sufficient and age-associated for germ-cell meiosis and differentiation in testes by direct regulating critical regulators. This study advances our understanding of the regulation of germ-cell meiosis and differentiation in the postnatal testis.

Remimazolam tosilate in upper gastrointestinal endoscopy: A multicenter, randomized, non-inferiority, phase III trial.

BACKGROUND AND AIM: Remimazolam tosilate (RT) is a new short-acting GABA(A) receptor agonist, having potential to be an effective option for procedural sedation. Here, we aimed to compare the efficacy and safety of RT with propofol in patients undergoing upper gastrointestinal endoscopy. METHODS: This positive-controlled, non-inferiority, phase III trial recruited patients at 17 centers, between September 2017 and November 2017. A total of 384 patients scheduled to undergo upper gastrointestinal endoscopy were randomly assigned to receive RT or propofol. Primary endpoint was the success rate of sedation. Adverse events (AEs) were recorded to evaluate safety. RESULTS: The success rate of sedation in the RT group was non-inferior to that in the propofol group (97.34% vs 100.00%; difference in rate -2.66%, 95% CI -4.96 to -0.36, meeting criteria for non-inferiority). Patients in the RT group had longer time to adequate sedation (P < 0.0001) but shorter time to fully alert (P < 0.0001) than that in the propofol group. The incidences of hypotension (13.04% vs 42.86%, P < 0.0001), treatment-related hypotension (0.54% vs 5.82%, P < 0.0001), and respiratory depression (1.09% vs 6.88%, P = 0.0064) were significantly lower in the RT group. AEs were reported in 74 (39.15%) patients in the RT group and 114 (60.32%) patients in the propofol group, with significant difference (P < 0.0001). CONCLUSION: This trial established non-inferior sedation success rate of RT compared with propofol. RT allows faster recovery from sedation compared with propofol. The safety profile is favorable and appears to be superior to propofol, indicating that it was feasible and well tolerated for patients.

Male and female birth attendance and assistance in a species of non-human primate (Rhinopithecus bieti).

Birth attendance, or midwifery service, is an important characteristic in human evolution, and has been argued to separate our lineage from other taxa in the animal kingdom. Recent studies, however, indicate that similar or analogous behaviors also may occur in a small number of nonhuman primate species. Here, we report the first case of both male and female attendance and female birth assistance in a wild species of nonhuman primate, the black-and-white snub-nosed monkey (Rhinopithecus bieti). At our field site in Yunnan, China we observed a diurnal birth event in which the leader male of a one-male unit (OMU) remained in close- proximity (0-2 m) to the parturient, groomed her, and remained vigilant over a five hour pre- and postpartum period. In addition, a multiparous female member of the OMU also remained in close proximity to the soon-to-be mother, helped to pull the neonate from the birth canal, took the neonate from the new mother within 15 s of the birth, held the infant for 20 min, and then severed the umbilical cord. For the next several days the leader male traveled in close-proximity to the new mother and four days after the birth event, we observed him to share food with her. Given that diurnal births are extremely rare in this primate species; it remains unclear the degree to which the events we observed commonly occur during nighttime births. We argue that adult male and female black-and-white snub-nosed monkeys are highly attracted to young infants, and birth attendance and birth assistance in this, and certain other primate species, may play a critical role in maternal and infant survivorship.

Proximate causes of dispersal for female Yunnan snub-nosed monkeys.

Individual dispersal trends, unquestionably important for species ecology and evolution, are affected by multiple factors. Understanding the factors that influence female dispersal strategies offers important insight into primate dispersal mechanisms and female choice. To investigate the proximate causes of dispersal in female Yunnan snub-nosed monkeys (Rhinopithecus bieti), we observed and analyzed nine years of detailed dispersal and demographic data from a population of R. bieti in Xiangguqing, Baimaxueshan Nature Reserve, Yunnan Province, China. Results showed that females who lived long-term in a one-male unit (OMU), without giving birth and with few or no relatives, were more likely to leave that OMU. In addition, an OMU led by an outgroup male and containing more female relatives was significantly more likely to be chosen for immigration. Conversely, greater male age, longer male tenure, and more potentially fertile females discouraged immigration into an OMU. These results suggest that reproduction, male quality, and kin cooperation play the largest roles in female Yunnan snub-nosed monkey dispersal.

[Injection of botulinum-A toxin into bulbospongiosus muscle for primary premature ejaculation: A preliminary clinical study].

OBJECTIVE: To evaluate the efficacy and safety of injection of botulinum-A toxin into the bulbospongiosus muscle in the treatment of primary premature ejaculation (PPE). METHODS: According to the inclusion criteria, we randomly assigned 70 outpatients with PPE to a trial and a control group of equal number, the former injected with 100 U botulinum-A toxin at 10 U/ml and the latter with the same volume of saline into the bulbospongiosus muscle. Then, we obtained the intravaginal ejaculatory latency time (IELT), scores of the Premature Ejaculation Profile (PEP), Male Sexual Health Questionnaire-Ejaculatory Dysfunction (MSHQ-EjD), and Hospital Anxiety and Depression Scale (HADS), and the incidence of adverse reactions between the two groups before and 4 weeks after treatment. RESULTS: Complete data were obtained from 69 of the patients, 34 in the trial and 35 in the control group. The effectiveness rate was 47.06% (16/34) in the former but 0 in the latter. At 4 weeks after treatment, the patients of the trial group showed a significantly longer IELT than the controls and the baseline (ï¼»2.35 ± 1.83ï¼½ vs ï¼»0.79 ± 0.21ï¼½ and ï¼»0.74 ±+ 0.27ï¼½ min, P < 0.01) and the controls. The patients in the trial group, in comparison with those in the saline control group and the baseline, also exhibited significant improvement in the scores of PEP-ejaculation control (1.21 ± 1.04 vs 0.49 ± 0.56 and 0.47 ± 0.51, P < 0.05), PEP-sexual satisfaction (1.32 ± 1.01 vs 0.71 ± 0.57 and 0.79 ± 0.48, P < 0.05), PEP-PE-related distress (2.12 ± 1.01 vs 2.80 ± 0.68 and 2.76 ± 1.26, P < 0.05), and PEP-PE-induced difficult relationship with the partners (1.38 ± 0.70 vs 2.37 ± 0.55 and 2.12 ± 1.49, P < 0.05). The sexual satisfaction score of the female partners after treatment was markedly improved in the trial group as compared with the control group and the baseline (1.18 ± 1.00 vs 0.57 ± 0.50 and 0.62 ± 0.60, P < 0.05). There were no statistically significant differences in MSHQ-EjD and HADS scores between the two groups before and after treatment. Adverse reactions were observed in 6 cases (17.65%) in the trial group, including 4 cases of decreased erectile hardness (11.76%) and 2 cases of incomplete urination (5.88%), which occurred from the 3 to 4 days after injection, and those with decreased erectile hardness could complete sexual intercourse without any other treatment and recovered after 3 weeks. CONCLUSIONS: Injection of botulinum-A toxin into the bulbospongiosus muscle can be used as an option for the treatment of PPE. Its clinical application value, however, needs to be verified by further studies with larger samples.

Targeted Epidural Blood Patch Treatment for Refractory Spontaneous Intracranial Hypotension in China.

Objective An epidural blood patch (EBP) is the mainstay of treatment for refractory spontaneous intracranial hypotension (SIH). We evaluated the treatment efficacy of targeted EBP in refractory SIH. Methods All patients underwent brain magnetic resonance imaging (MRI) with contrast and heavily T2-weighted spine MRI. Whole spine computed tomography (CT) myelography with non-ionic contrast was performed in 46 patients, and whole spine MR myelography with intrathecal gadolinium was performed in 119 patients. Targeted EBPs were placed in the prone position one or two vertebral levels below the cerebrospinal fluid (CSF) leaks. Repeat EBPs were offered at 1-week intervals to patients with persistent symptoms, continued CSF leakage, or with multiple leakage sites. Results Brain MRIs showed pachymeningeal enhancement in 127 patients and subdural hematomas in 32 patients. One hundred fifty-two patients had CSF leakages on heavily T2-weighted spine MRIs. CSF leaks were also detected on CT and MR myelography in 43 and 111 patients, respectively. Good recovery was achieved in all patients after targeted EBP. No serious complications occurred in patients treated with targeted EBP during the 1 to 7 years of follow-up. Conclusions Targeted and repeat EBPs are rational choices for treatment of refractory SIH caused by CSF leakage.

HOXA13 is associated with unfavorable survival and acts as a novel oncogene in prostate carcinoma.

AIM: To investigate the clinical relevance and functional role of HOXA13 in prostate cancer Methods: PCR, western blot and immunohistochemistry were performed to determine the expression. Kaplan-Meier and Cox regression survival analyses investigated the clinical relevance. Cell viability, flow cytometry and transwell assays were used to determine the functional roles. RESULTS: HOXA13 expression is sharply increased in carcinoma tissues and is significantly associated with poor prognosis of prostate cancer patients. Interestingly, nucleus not cytoplasm HOXA13 expression is associated with unfavorable survival of the patients. Furthermore, nucleus HOXA13 expression represents an unfavorable and independent prognosis factor of histological grade 2 or Gleason grade <8 patients. Functionally, forced expression of HOXA13 obviously promotes tumor cell proliferation, migration and invasion, whereas inhibits tumor cell apoptosis. CONCLUSION: HOXA13 is an unfavorable prognostic factor and a novel oncogene for prostate cancer.

[Vacuum sealing drainage as an adjuvant treatment of penile and scrotal gangrene: Clinical analysis of 4 cases].

OBJECTIVE: To search for an optimal strategy for the treatment of penile and scrotal gangrene by analyzing the clinical effect of vacuum sealing drainage (VSD) as an adjuvant treatment on this disease. METHODS: We retrospectively analyzed the clinical data about 4 cases of penile and scrotal gangrene treated by VSD as an adjuvant treatment from January 2015 to June 2016. The 4 patients all underwent early extensive and radical debridement of gangrene of the scrotum and penis and received intravenous injection of two broad-spectrum antibiotics, followed by VSD for wound drainage and irrigation. RESULTS: Adequate wound drainage was achieved in all the 4 cases, the gangrene range rapidly localized and testicular necrosis avoided. The wound surface healed satisfactorily after cleansing and suturing. The patients were followed up for 3 months after discharged from the hospital and none experienced recurrence. CONCLUSIONS: VSD combined with early adequate debridement can effectively localize the gangrene range, significantly reduce the frequency of changing dressings and shorten the hospitalization time of the patient, and therefore is a very effective adjuvant treatment of penile and scrotal gangrene.

Amide-linked local anesthetics induce apoptosis in human non-small cell lung cancer.

BACKGROUND: A retrospective analysis of patients undergoing cancer surgery suggested that using local anesthetics could reduce cancer recurrence and improve survival rate. Previous studies have indicated that local anesthetics may induce apoptosis in several kinds of cells in vitro, but the mechanism is unclear. METHODS: Cell viability was analyzed by MTS; reactive oxygen species (ROS), mitochondrial membrane potential (MMP, ∆Ψm), cell cycle distribution, and cell apoptosis assay were detected by flow cytometry; DNA damage was measured by comet assay; cell invasion and migration were observed by microscopy; The expression level of related proteins was detected by western blot assay. RESULTS: The results indicated that lidocaine and ropivacaine could decrease viability, induce G0/G1 phase arrest and apoptosis in human non-small cell lung cancer (NSCLC) cells A549 and H520. Invasion and migration were suppressed. Western blot indicated the related apoptotic pathways proteins changed accordingly. Additionally, lidocaine and ropivacaine downregulated ∆Ψm, provoked DNA damage, upregulated ROS production and activated mitogen-activated protein kinase (MAPK) pathways in A549 and H520 cells. CONCLUSIONS: The cytotoxic effect of amide-linked local anesthetics on NSCLC cells were mainly due to apoptosis. The antitumor mechanism of lidocaine and ropivacaine may involve apoptotic pathways and MAPK pathways.

Saikosaponin-d attenuates ventilator-induced lung injury in rats.

Saikosaponin-d is one of the main bioactive components in the traditional Chinese medicine Bupleurum falcatum L and possesses anti-inflammatory and immune-modulatory properties. The current study aimed to investigate the protective effects of saikosaponin-d on ventilator-induced lung injury (VILI) in rats. We found that saikosaponin-d treatment significantly attenuated the pathological changes of lungs induced by mechanical ventilation. Administration of saikosaponin-d reduced the pulmonary neutrophil infiltration as well as the MPO concentrations. Saikosaponin-d also decreased the expression of pro-inflammatory cytokines including MIP-2, IL-6 and TNF-α. Meanwhile, the expression of anti-inflammatory mediators, such as TGF-ß1 and IL-10, was obviously elevated after saikosaponin-d administration. Saikosaponin-d remarkably reduced the oxidative stress and apoptosis rate in lung tissues. On the molecular level, saikosaponin-d treatment obviously downregulated the expression of caspases-3 and the pro-apoptotic protein bax, and promoted the expression level of anti-apoptotic protein bcl-2. Collectively, our study demonstrated that saikosaponin-d may attenuate ventilator induced lung injury through inhibition of inflammatory responses, oxidative stress and apoptosis.

[Spatial distribution and accumulation of heavy metal in arable land soil of China].

Based on the domestic and foreign published papers about soil heavy metal contents, the present study explored the spatial variations of heavy metal contents in agricultural soil in China. Totally, 173 studies on soil Pb, 138 on Cd, 156 on Cu, 139 on Zn and 140 on Cr were collected. Firstly, the abnormal values were selected and removed, then the spatial distributions were obtained through Kriging method and the average values in the provinces were calculated. Results show that the spatial distributions of heavy metals have obvious regional characteristics and the southwest part of China has relatively high heavy metal concentrations in soils. Compared with the background value of soil heavy metal concentrations, nearly all of the provinces have higher Pb, Cd, Cu and Zn concentrations. Pb and Cd have the most obviously higher values than the background values. The highest difference of Pb concentration is in Yunnan Province with 1.91 times of the background, and the highest Cd difference is in Liaoning Province with 23.04 times of the background; The highest Zn enrichment is in Yunnan, with 1.55 times of the background; and the highest Cu difference with 2.92 times of the background value.

Highly enantioselective Michael addition promoted by a new diterpene-derived bifunctional thiourea catalyst: a doubly stereocontrolled approach to chiral succinimide derivatives.

A doubly stereocontrolled organocatalytic asymmetric Michael addition to the synthesis of substituted succinimides is described. Starting from aldehydes and maleimides, both enantiomers of the succinimides could be obtained in high to excellent yields (up to 98%) and enantioselectivities (up to 99%) when one of the two special chiral diterpene-derived bifunctional thioureas was individually used as a catalyst. Moreover, these catalysts can be efficiently used in large-scale catalytic synthesis with the same level of yield and enantioselectivity.

Influence of different anesthesia on liver and renal function in elderly patients undergoing laparoscopic colon or rectal resection.

BACKGROUND/AIMS: To investigate the influence of different anesthesia methods on liver and renal function in elderly patients undergoing laparoscopic colon or rectal resection. METHODOLOGY: Forty ASA I-II elderly patients undergoing elective laparoscopic colon or rectal resection were randomly divided into 2 groups (n=20 each): Group A: routine general anesthesia and Group B: general combined epidural anesthesia. All patients received general anesthesia, tracheal catheterized and mechanical ventilation. Data of liver and renal function were noted at these time points: before operation (T1), during operation (T2), 1-day after operation (T3), 2-day after operation during bowel anastomoses (T4), 3-day after operation (T5). Duration of surgery, blood loss, urine output and intravenous fluid volume was registered. RESULTS: Compared with group A, the total fluid volume and urine volume were increased in group B (p<0.05), while the amount of fentanyl was decreased (p<0.05). TP, TBIL and DBIL between the two groups were not significantly different (p>0.05). Compared with group A, group B ALT/BUN decreased at T2 and T3, AST decreased at T2, Cr at T3 decreased, ALB decreased at T2 (p<0.05). CONCLUSIONS: Continuous epidural block compound general anesthesia in elderly laparoscopic colorectal resection surgery is more conducive to the protection of perioperative liver and kidney function.

Effect of stroke volume variability- guided intraoperative fluid restriction on gastrointestinal functional recovery.

To investigate the effect of stroke volume variability(SVV)-guided intraoperative fluid restriction on gastrointestinal functional recovery and postoperative outcome after gastrointestinal surgery. Forty ASA I-II patients undergoing elective gastrointestinal surgery were randomly divided into 2 groups (n=20 each):group A routine fluid administration and group B restricted fluid administration. SW value was maintained at 5-7 in group A and 11-13 in group B. All patients received general anesthesia, tracheal catheterized and mechanical ventilation. Hemodynamic monitoring parameters (MBP, HR, CVP, CO) were noted at 5 time points. The hemodynamic parameters were maintained within normal limits during operation in both groups. The intraoperative intravenous fluid volume in group B was significant less than in group A (p<0.01).Urine output in group A was significant less than in group B (p<0.05). Stroke volume variation measured from Edwards Flotrac sensor and Edwards Vigileo monitor could be a security and sensitive parameter as an index of volume administration. In elective gastrointestinal surgery, volume resuscitation with a goal SVV of11-13 not only reduced intravenous fluid volume but also maintained the stable hemodynamic and tissue perfusion, enhanced gastrointestinal functional recovery and reduced the length of hospital stay

[Risk factors for excessive bleeding in patients undergoing open heart surgery with cardiopulmonary bypass].

OBJECTIVE: To evaluate the pre- and intraoperative risk factors associated with excessive bleeding during the perioperative period in adult patients undergoing open heart surgery with cardiopulmonary bypass (CPB). METHODS: A total of 1079 consecutive patients undergoing open heart surgery with CPB from January 2001 to May 2010 were included (except for emergency operation). The possible risk factors associated with excessive bleeding were retrospectively analyzed. Patients who received ≥ 7 units of RBC or had a re-operation during which no active bleeding point was found within one day of operation were classified as excessive bleeding. According to the occurrence of excessive bleeding, they were divided into 2 groups: excessive and non-excessive bleeding groups. The possible risk factors associated with excessive bleeding were retrospectively analyzed. Univariate analysis and multivariate Logistic regression analysis were used to examine the relationship between these factors and excessive bleeding. RESULTS: Among them, 120 (11.1%) developed excessive bleeding. Multivariate Logistic analysis indicated that the risk factors for excessive bleeding were age (OR = 4.533, 95%CI 2.624 - 7.831), previous sternotomy (OR = 2.781, 95%CI 1.410 - 5.486), preoperative hematocrit concentration (OR = 0.896, 95%CI 0.861 - 0.932), CPB duration (OR = 2.782, 95%CI 1.791 - 4.322) and type of procedure (OR = 2.292, 95%CI 1.376 - 3.817). CONCLUSION: Age ≥ 65 years, previous sternotomy, preoperative low hematocrit concentration, CPB duration ≥ 120 min and complex operation were the significant predictors for excessive bleeding in patient undergoing open heart surgery with CPB.