Retraction of: The Significance of Thromboelastogram in Predicting Postpartum Hemorrhage and Guiding Blood Transfusion.

This retracts the article DOI: 10.7754/Clin.Lab.2021.210317.

The Significance of Thromboelastogram in Predicting Postpartum Hemorrhage and Guiding Blood Transfusion.

BACKGROUND: The aim of this study was to probe into the significance of the thromboelastogram (TEG) in predicting postpartum hemorrhage and guiding blood transfusion. METHODS: In total, our work selected 200 cases of postpartum hemorrhage patients admitted to the hospital from April 2017 to November 2020 as the research objects, namely the postpartum hemorrhage group. Another 200 cases without postpartum hemorrhage during hospitalized delivery during the same period were chosen as the no postpartum hemorrhage group. The 200 patients complicated with postpartum hemorrhage were allocated into two groups in accordance with whether the blood transfusion was guided by TEG, 100 cases in each group. The changes of blood coagulation as well as TEG indexes in the two groups with/without postpartum hemorrhage were compared, and the diagnostic significance of TEG detection as well as blood coagulation examination for postpartum hemorrhage were analyzed. The TEG index changes before and after infusion of blood products under TEG guidance were counted. The bleeding time and bleeding volume and the blood products infusion with/without TEG guidance were compared. Based on the changes in the coagulation index (CI) of TEG indexes and in D-dimer, correlation analysis between bleeding time and bleeding volume was carried out, predicting the ROC curve and calculating the AUC area through drawing TEG indexes. RESULTS: In the comparison of coagulation indexes, the APTT, PT as well as TT of the postpartum hemorrhage group were longer than those of the no postpartum hemorrhage group (p < 0.05), and the FIB level was lower than that of the no postpartum hemorrhage group (p < 0.05). The TEG indexes of R, MA, and K in the observation group were greater than those in the control group (p < 0.05); Angle-α and CI were lower than those in the control group (p < 0.05). The sensitivity and specificity of patients receiving TEG detection were higher than those receiving coagulation examination. After injecting blood products, the R, MA, as well as K of TEG indexes were less than before (p < 0.05), and the Angle-α as well as CI were greater than before (p < 0.05). If the patients were guided by TEG, the bleeding time was shorter (p < 0.05) and the bleeding volume was less than those not (p < 0.05). The dosage of blood products, including erythrocytes, fresh frozen plasma, cold precipitation as well as platelets given to those received TEG guidance was less than those who did not (p < 0.05). CI was negatively correlated with the change of D-dimer (p < 0.05), CI was negatively correlated with the change of bleeding time (p < 0.05), and CI was negatively correlated with changes in bleeding volume (p < 0.05). Using R we predicted postpartum hemorrhage AUC area = 0.772. Using MA our team predicted postpartum hemorrhage AUC area = 0.458. Using K we predicted postpartum hemorrhage AUC area = 0.924. Using Angle-α our team predicted postpartum hemorrhage AUC area = 0.728. CONCLUSIONS: For patients with postpartum hemorrhage, applying TEG to guide blood transfusion is available to more promptly guide clinical blood transfusion, reduce the blood transfusion volume, and bleeding volume, thus more effectively promoting the return of blood coagulation to normal and improving the prognosis.

[Identification of two novel variants of the PCCB gene in a pedigree affected with propionic acidemia].

OBJECTIVE: To detect pathogenic variants in a pedigree affected with propionic acidemia (PA). METHODS: The proband was subjected to high-throughput next-generation sequencing. Suspected variants were validated by Sanger sequencing of his family members. mRNA was extracted from peripheral blood lymphocytes from the proband's father in order to verify the impact of the splicing variant by RT-PCR combined with Sanger sequencing. The pathogenicity of the missense variant was predicted by using PolyPhen-2, Mutation Taster, SIFT, COBALT and HOPE software. RESULTS: The proband was found to harbor compound heterozygous variants of the PCCB gene, namely c.184-2A>G and c.733G>A (p.G245S), which were respectively inherited from his father and mother. RT-PCR combined with Sanger sequencing confirmed skipping of exon 2 during transcription. Bioinformatic analysis indicated the c.733G>A (p.G245S) variant to be damaging. CONCLUSION: The two variants of the PCCB gene probably underlay the disease in this patient. Above findings have enriched the spectrum of PCCB gene variants.

[Clinical Prognostic Factors Analysis of Initially Treated AML Children with t(8;21)/RUNX1-RUNX1T1].

OBJECTIVE: To investigate the clinical prognostic factors of initially-treated AML children with t(8;21)/RUNX1-RUNX1T1+. METHODS: Clinical data of 41 initially-treated AML children with t(8;21)/RUNX1-RUNX1T1+ in our hospital in period from January 2009 to January 2017 were retrospectively analyzed. The baseline clinical characteristics, cumulative recurrence, event-free survival (EFS) and overall survival (OS) were recorded, and the influencing factors of prognosis were evaluated by χ2 test and Cox regression model. RESULTS: The complete remission (CR) rates in the first course and the second course of induction chemotherapy were respectively 82.93% (34/41) and 97.56% (40/41). The median EFS time and OS time were 30 months and 31 months respectively. The EFS rate and OS rate of children with CR after the first treatment course were significantly higher than those of children without CR (P＜0.05). The EFS rate of male children was significantly higher than that of female children (P＜0.05). The OS rate of children < 10 years old was significantly higher than that of children≥10 years old (P＜0.05). The expression level of RUNX1-RUNX1T1 gene after the second induction remission was the influencing factor of cumulative recurrence rate, EFS rate and OS rate in children (P＜0.05). Multivariate analysis by Cox regression model showed that the decreased levels of RUNX1-RUNX1T1 gene expression < 3 log after the second induction remission was the independent risk factor for EFS rate and OS rate in children (P＜0.05). The cumulative recurrence rate of children with RUNX1-RUNX1T1 gene expression increase for＞1 log after decreased 3 log was significantly higher than that of children with≤1 log (P＜0.05). CONCLUSION: Iuithally-treated AML children with t(8;21)/RUNX1-RUNX1T1+ show the fine clinical prognosis after standard chemotherapy. The expression level of RUNX1-RUNX1T1 gene should be closely relates with the recurrence and long-term survival of AML children.