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Extensive hemorrhage is a significant cause of mortality in trauma patients. Tranexamic acid has been used for controlling bleeding in cardiovascular surgeries and dental manipulations in patients with hemophilia. However, in traumatic patients with bleeding, its use dates back to more recent years. This study aims to examine the effects of this drug on reducing mortality and blood transfusion rate in trauma patients with significant hemorrhage. A total of 60 patients with significant trauma-related hemorrhage (systolic blood pressure < 90 mmHg/heart rate > 110/min) from the emergency department of Imam Reza Hospital (Tabriz, Iran), were randomized in two groups. The case group received intravenous Tranexamic acid (1 g in 10 min and then 1 g over 8 h). The control group received placebo. Rate of transfusion and rate of one-month mortality were compared between the study groups. The mean ICU stay and overall hospitalization times did not have significant difference between two groups (p<0.05). Transfusion of packed cells was 6.03±1.50 and 6.03±1.22 units in case and control groups respectively. Transfusion of fresh frozen plasma (FFP) was 2.50±1.36 and 3.03±0.96 units in case and control groups respectively (p=0.09). Transfusion of platelets was 0.40±0.20 1.33±0.31 units in case and control groups respectively (p=0.01). Three patients (10%) in the case group and 4 patients (13.3%) in the control group were expired (p=0.50). Tranexamic acid is safe and effective in reducing platelet transfusion rate in patients with trauma-related significant hemorrhage. However, transfusion need and mortality would not reduce by its use in trauma patients.

Objective: Acute inflammation of the appendix is a very common finding in patients representing the emergency department. Here, we assessed the levels of the serum laboratory biomarkers in the patients with complicated (defined by the presence of perforation, abscess, or peritonitis) and simple appendicitis. Methodology: This observational study was conducted in Sina Hospital, Tabriz-Iran, between March 2019 and August 2019. Data regarding age, sex, body temperature, length of hospital stays, clinical signs and symptoms, and time of symptom onset for each patient. Laboratory values including white blood cells (WBC) count, neutrophil percentage, erythrocyte sedimentation rate (ESR), C-reactive protein (CRO), mean platelet volume (MPV), and lactate dehydrogenase (LDH) were evaluated. Results: A total of 279 patients were enrolled in the study. 131 patients (46.9%) had complicated and 148 (53.0%) had simple appendicitis. Mean body temperature (P-value <0.05) and CRP levels (P-value <0.0001), were significantly higher in the complicated appendicitis group. (P-value >0.05). There were no significant differences regarding WBC, neutrophil, 1 st and 2 nd hour ESR, MPV, and LDH levels, and mean length of hospital stay (P-value>0.05). Conclusion: CRP concentrations are reliable markers showing an increased risk of developing complications in acute appendicitis patients.

Brachiobasilic AVF fistula provides a suitable option for vascular access in cases with failed previous AVF. Relocation of basilic vein for brachiobasilic AVF is technically feasible, safe and with excellent patency in short-term and complication rates are acceptable.

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Background: gastric cancer (GC) is one of the common cancers with a high mortality rate and complex pathogenesis. In recent years many studies focused on the roles of non-coding RNA in GC biology. Long noncoding RNAs (lnc-RNAs) like HOTAIR and SNHG-7 are a class of non-coding RNA that can affect the cell’s biology by sponging of micro-RNAs. Recent studies reveal the relation between these lnc-RNAs and miR-34a expression which can affect various molecular pathways in malignant cells. Methods: GeneAll Trizol RNA extraction kit (Korea) was used to extract total RNA according to the supplied procedures and gene expression was evaluated. The qRT-PCR assay was performed to evaluate the expression levels of miR-34a, HOTAIR, and SNHG-7 in GC and paired marginal tissue specimens. The AUC of the ROC curve was estimated based on their expression in GC and gastric normal tissues to evaluate their diagnostic accuracy.Results: Expression levels of miR-34a were higher in adjacent marginal samples compared to GC tissue samples. We noted significantly higher levels of HOTAIR expression in GC samples compared to non-tumor adjacent tissue samples and the expression of HOTAIR in GC tissues was negatively correlated with mir-34a. Similarly, we noted GC tissue samples showed higher levels of SNHG-7 expression and that SNHG-7 expression was negatively correlated with mir-34a. Regarding the clinicopathological factors, miR-34a expression was lower in patients with advanced GC, while enhanced expression of HOTAIR and SNHG-7 was noted in these patients. Conclusion: Our findings suggested that miR-34a, HOTAIR, and SNHG-7 expression levels have high potential as diagnostic markers for discriminating GC patients from normal cases. In Addition, there is a negative correlation between miR-34a with two other genes which suggests the regulatory effects of HOTAIR and SNHG-7 on miR-34a.

Background MicroRNAs (miRs) are involved in the pathogenesis of various malignancies such as colorectal cancer through regulating multiple cellular processes, including cell proliferation, cell cycle, apoptosis and migrationMiR-21 and let-7 are two important genes that have confirmed in this pathway. The role of the let-7 gene as a gene tumor process in various cancers and the role of miR-21 in the development and progression of cancer has been conclusively identified also this gene has an oncogenic role in various cancers. In this study, the expression patterns of miR-21 and let-7 in serum and stool samples of colorectal cancer patients were evaluated. Materials and Methods During the present study, 120 samples including 40 serum samples of CRC and 40 stool samples from the same patients and 40 healthy samples were collected. After total RNA extraction, real-time PCR was used to measure changes in genes expression. Statistical analysis of data was performed with GraphPad Prism statistical software (Version 6.0) with a significance level of 5%. Results The relative expression level of miR-21 in the serum samples of CRC increased compared to the healthy group, which was statistically significant. On the other hand, the relative expression level of let-7g in the serum samples of CRC showed a significant decrease compared to the healthy sample. In stool samples, the expression changes of either of the two genes were not significant. Conclusion Our findings indicate that the relative expression of miR-21 and let-7g genes can be used as a diagnostic or predictive biomarker in colorectal cancer serum samples. While, this is not the case in stool samples. Moreover, further investigations at the protein level should be performed.