Comparison of the effects of different blood conservation techniques in elderly patients undergoing total hip arthroplasty.

Background: To probe into the influences of different blood conservation techniques on the postoperative coagulation function and prognosis of elderly patients receiving Total Hip Arthroplasty (THA). Methodology: A total of 60 patients were randomly divided into Autologous Blood Transfusion (ABT) group (n=30) and ANH group (n=30). For patients in the ABT group, an autologous blood recovery machine was used to recover, wash and filter the surgical field blood. For those in the Acute Isovolumic Hemodilution (ANH) group, blood was collected preoperatively from the central vein and stored in a citrate anticoagulant blood storage bag, while the same amount of hydroxyethyl starch was injected into the peripheral vein to dilute the blood. After Mai bleeding steps of the operation were completed, the autologous blood of patients was transfused back in both groups. The clinical indicators of patients in each group were observed. Results: 48 h after operation, the ANH group obtained a higher level of hemoglobin (Hb), shorter Activated Partial Thromboplastin Time (APTT), and a lower expression rate of platelet activating factor CD62P than the ABT group. Conclusion: The ANH group exhibits higher content of hemoglobin and fewer platelet (Plt)activating factors produced than the ABT group, while no significant difference in the shortened length of hospital stays is found.

The efficacy and safety of 5-fluorouracil based adjuvant therapy in resected biliary tract cancer: A systematic review and meta-analysis.

OBJECTIVES: The adjuvant therapy (AT) for biliary tract cancer (BTC) patients after surgery has always been controversial. More therapeutic regimens and high-quality evidence were needed to evaluate AT's survival benefit further. Thus, this study was performed to investigate the efficacy and safety of the 5-fluorouracil (5-FU) regimen in resected BTC patients. METHODS: PubMed, Cochrane Library, Web of Science, and the Embase were systematically searched from inception to Feb.3, 2021, for eligible studies. The pooled analyses were performed using Review Manager, Stata, and SPSS software. RESULTS: A total of 9 trials involving 1339 participants were included in the meta-analysis. Resected BTC patients could significantly benefit from a 5-FU regimen (HR:0.51, 95%CI, 0.38-0.69, P<0.0001), regardless of gallbladder carcinoma (GBC) or cholangiocarcinoma (CCA). Moreover, both adjuvant chemotherapy (HR:0.61, 95%CI, 0.47-0.79, P=0.0003) and chemoradiotherapy (HR:0.35, 95%CI, 0.14-0.83, P=0.02) could significantly improve clinical survival of resected BTC patients than the surgery alone group. In the subgroup analyses, patients with node-positive (P=0.02) or vascular invasion disease (P=0.002) could better benefit from postoperative AT. CONCLUSION: This study provides the latest evidence to support the 5-FU regimen in resected BTC patients regardless of GBC or CCA. Furthermore, high-risk patients are more likely to benefit from it, such as node-positive or vascular invasion disease.