Effects of Autologous Platelet Rich Plasma on Intraoperative Transfusion and Short-Term Outcomes in Total Arch Replacement (Sun's Procedure): A Prospective, Randomized Trial.

OBJECTIVE: To observe the effect of collecting and retransfusing autologous platelet rich plasma (aPRP) on the amount of allogeneic blood usage in total arch replacement (Sun's surgery) and the outcomes 30 days after surgery. DESIGN: A prospective, randomized trial. SETTING: A tertiary university hospital specialized in cardiovascular diseases. PARTICIPANTS: The study comprised 120 patients undergoing Sun's surgery for Stanford type A acute aortic dissection. INTERVENTIONS: aPRP was harvested before incision and was re-transfused after heparin neutralization for patients in the treatment group. MEASUREMENTS AND MAIN RESULTS: There was no significant difference in preoperative demographic data between the 2 study groups. Intraoperative transfusions of erythrocyte (p = 0.009), plasma (p = 0.017), cryoprecipitate (p = 0.002), and platelets (p < 0.001) in the treatment group were reduced significantly. In addition, less blood loss was observed in the treatment group (p = 0.002). The durations of postoperative mechanical ventilation (p = 0.029) and hospitalization (p = 0.002) of the treatment group were significantly shorter. There were no statistically significant differences in the length of intensive care unit stay, the incidence of complications, and mortality 30 days after surgery. CONCLUSION: In total arch replacement (Sun's surgery), collecting and retransfusing aPRP reduced intraoperative transfusions of erythrocyte, plasma, and cryoprecipitate and decreased the duration of postoperative mechanical ventilation and hospitalization. This technique had no significant effect on the incidence of complications and mortality 30 days postoperatively.

[Detection of tick and tick-borne pathogen in some ports of Inner Mongolia].

OBJECTIVE: To investigate the distribution, composition and situation of natural infection pathogen of tick species in the main ports of Inner Mongolia. METHODS: All ticks were collected manually with white cloth, from the grassland and searching for the hosts followed by detection of pathogens, with PCR. RESULTS: 1313 ticks identified, belonged to 1 family, 4 geniuses and 7 species in the three surveyed areas, with Dermacentor nuttallia distributed in the Ceke, Mandula and Manzhouli bordering ports. 69.08% of the total species were discovered at Port Ceke, with Rhipicephalus pumilio as the predominant one, which accounted for 74.86%. 5 kinds of tick-borne disease pathogens were detected from ticks in these three bordering ports while only Coxiella burnetii was found at the Port Ceke. In these three ports, the average infection rates of Lyme disease borrelia, Human babesia microti, Spotted fever group Rickettsia, Coxiella burnetii, Ehrlichiosis were 15.08%, 3.35%, 1.98%, 1.07%, 0.99% respectively. The positive rate of tick infected with Borrelia burgdorferi were 13.56%,22.88%,5.00% in the 3 bordering ports, respectively with significant differences. The positive rates of Babesia microti and Spotted fever group Rickettsia infections were also significantly different among these areas. CONCLUSION: The natural infection rates of the above mentioned five kinds of tick-borne pathogens were different in the Ports Ceke, Mandula and Manzhouli.