Objective: To investigate the effects of butyphthalide + alteplase (rt-PA) intravenous thrombolysis on the diffusion-weighted imaging (DWI) characteristics, coagulation function and neurological function in patients w...Objective: To investigate the effects of butyphthalide + alteplase (rt-PA) intravenous thrombolysis on the diffusion-weighted imaging (DWI) characteristics, coagulation function and neurological function in patients with acute cerebral infarction. Methods: The patients with acute cerebral infarction who were admitted to our hospital between April 2015 and October 2018 and with the onset time 4.5 hours were selected and divided into the observation group receiving butyphthalide + rt-PA intravenous thrombolysis and the control group receiving rt-PA intravenous thrombolysis by random number table. The differences in DWI parameter apparent diffusion coefficient (ADC), coagulation function indexes and neurological function indexes were compared between the two groups. Results: At 7 and 14 days after treatment, the ADC values of both groups were significantly increased, and the ADC values of the observation group were significantly higher than those of the control group;at 7 days after treatment, the prothrombin time (PT) and activated partial thromboplastin time (APTT) levels in both groups were significantly prolonged whereas fibrinogen (FIB), D-dimer (D-D), platelet activating factor (PAF), P-selectin, von Willebrand factor (vWF), neuron-specific enolase (NSE), S100B protein (S100B), malondialdehyde (MDA) and endothelin-1 (ET-1) contents were significantly decreased, and the APTT and PT levels in the observation group were significantly shorter than those in the control group whereas FIB, D-D, PAF, P-selectin, vWF, NSE, S100B, MDA and ET-1 contents were significantly lower than those in the control group. Conclusion: Butyphthalide + rt-PA intravenous thrombolysis can improve the DWI characteristics, coagulation function and neurological function of patients with acute cerebral infarction.展开更多
Objective:To investigate the effects of intravenous thrombolysis therapy with alteplase on neurological function,coagulation function and serum inflammatory factors in patients with acute cerebral infarction.Methods:A...Objective:To investigate the effects of intravenous thrombolysis therapy with alteplase on neurological function,coagulation function and serum inflammatory factors in patients with acute cerebral infarction.Methods:A total of 96 patients with acute cerebral infarction admitted to our hospital from September 2017 to October 2019 were randomly divided into two groups,with 48 patients in each group.The control group(n=48)received routine treatment,and the observation group received intravenous thrombolysis therapy with alteplase on the basis of routine treatment.The neurological deficit score,prothrombin time(PT),activated partial thromboplastin time(APTT),tumor necrosis factor-a level(TNF-α),and high-sensitivity C-reactive protein(hs-CRP)were compared between the two groups after 15 days of treatment.Results:After treatment,NIHSS scores in both groups were lower than those before treatment;PT levels were increased,while APTT,TNF-αand hs-CRP levels were all decreased in both groups,and the changes in the observation group were greater than those in the control group,with statistically significant difference(P<0.05).Conclusions:Intravenous thrombolysis therapy with alteplase can improve the neurological function,coagulation function and serum levels of inflammatory factors in patients with acute cerebral infarction,which is worthy of clinical application.展开更多
Objective:To investigate the effects of sevoflurane inhalation general anesthesia on serum IL-6,brain injury protein S100βand coagulation function in elderly patients undergoing total hip arthroplasty.Method:From May...Objective:To investigate the effects of sevoflurane inhalation general anesthesia on serum IL-6,brain injury protein S100βand coagulation function in elderly patients undergoing total hip arthroplasty.Method:From May 2017 to May 2019,84 patients,age 60-75 underwent total hip arthroplasty in our hospital.were randomly divided into two groups:group A(n=42)and group B(n=42).Group A was maintained with sevoflurane inhalation by general anesthesia and group B with propofol by intravenous anesthesia.The surgical related indexes and postoperative complications in the two groups were compared.The level of serum IL-6,S100β,Coagulation function index[platelet count(PLT),Fibrinogen(FIB),plasma D-dimer(D-D),activated partial enzyme activity time(APTT),prothrombin time(PT)],MMSE score and MoCA score were compared between two groups before and after operation.Results:There was no significant difference in anesthesia time,operation time,intraoperative bleeding and postoperative drainage(P>0.05).1h,1d and 7d after operation,the level of PLT,D-D and FIB in group A were significantly lower than that in group B(P<0.05),PT and APTT were significantly higher than that in group B(P<0.05).1h,1d and 7d after operation,the level of IL-6,S100βin group A were significantly lower than that in group B(P<0.05).1d after operation,the MMSE and MoCA scores in group B were significantly lower than those in group A(P<0.05).The incidence of lower extremity deep venous thrombosis(2.38%)and cognitive impairment(2.38%)in group A was lower than that in group B(14.29%,16.67%)(t1=3.896,P1=0.048;t2=4.974,P2=0.026).Conclusion:sevoflurane anesthesia can reduce the incidence of deep venous thrombosis and cognitive impairment of the lower extremity after operation in elderly patients with thr,stabilize the coagulation index of patients,and downregulate the expression of il-6 and S100β.展开更多
Objective:To observe the effect of Taohong Siyu Decoction on the coagulation function and the signaling pathway of PI3K(phosphatidylinositol 3-kinase)/AKT(protein kinase B)/mTOR(mammalian target of rapamycin)after fem...Objective:To observe the effect of Taohong Siyu Decoction on the coagulation function and the signaling pathway of PI3K(phosphatidylinositol 3-kinase)/AKT(protein kinase B)/mTOR(mammalian target of rapamycin)after femoral artery anastomosis in rabbits.Methods:30 New Zealand white rabbits were divided into blank control group,model control group,papavine hydrochloride injection group and low,medium and high dose groups of Taohong Siwu decoction by random number table method,with 5 rabbits in each group.The rabbits in the model control group,papavine hydrochloride injection group and low,medium and high dose groups of Taohong Siwu decoction were treated with the femoral artery simple intermittent end-to-end suture model.After the successful modeling,the low,medium and high dose groups of Taohong Siwu decoction were given the Taohong Siwu decoction,while the model control group,the blank control group and papavine hydrochloride injection group were given the same amount of normal saline.APTT(activated partial thromboplastin time),FIB(fibrinogen)and PI3K/AKT/mTOR concentrations were measured in aural venous blood samples from six groups of rabbits 30min before operation and 1d,2D,3D and 7d after operation,respectively.Statistical analysis was conducted on the data of the six groups.Results:Compared with blank control group,APTT of model control group was significantly shortened 1d to 7d after operation(P<0.05),FIB values were significantly increased from 1d to 7d after operation(P<0.05);Compared with model control group,APTT in Taohong Siwu decoction low-dose,medium-dose and high-dose groups were significantly prolonged 1d to 7d after operation(P<0.05),FIB value of Taohong Siwu decoction medium and high dose groups decreased significantly from 1d to 7d after operation(P<0.05),the FIB value of Taohong Siwu decoction low-dose group was significantly decreased from 2d to 7d after surgery(P<0.05);Compared with papaverine hydrochloride injection group,APTT in Taohong Siwu decoction medium dose group was significantly prolonged 2d to 7d after surgery(P<0.05),APTT of Taohong Siwu decoction high-dose group was significantly prolonged on 1d to 7d after operation(P<0.05).FIB in Taohong Siwu decoction medium and high dose groups decreased significantly 1d to 7d after operation(P<0.05);Compared with the blank control group,the expression concentrations of PI3K,Akt and mTOR in serum of the model control group were significantly increased from 1d to 7d after surgery(P<0.05);Compared with the model control group,the expression levels of PI3K,Akt and mTOR in serum were significantly increased in the low dose group of Taohong Siwu decoction and Papaverine Hydrochloride Injection group on postoperative 7 days(P<0.05),Taohong Siwu decoction high-dose group was significantly increased from 1d to 7d after surgery(P<0.05),the expression concentrations of PI3K and Akt in Taohong Siwu decoction medium dose group were significantly increased from 2d to 7d after operation(P<0.05),mTOR expression levels were significantly increased from 3d to 7d after operation(P<0.05);Compared with papaverine hydrochloride injection group,the expression concentrations of PI3K,Akt and mTOR in serum of Taohong Siwu decoction medium dose group were significantly increased from 3d to 7d after operation(P<0.05),the expression concentrations of PI3K and mTOR in Taohong Siwu decoction high-dose group were significantly increased from 1d to 7d after operation(P<0.05),and the expression concentration of Akt increased significantly from 3d to 7d after operation(P<0.05).Conclusion:The Taohong Siwu decoction can improve the coagulation function of rabbit femoral artery anastomosis,prevent thrombosis,activate PI3K/Akt/mTOR signaling pathway,promote angiogenesis,and improve tissue ischemia after artery anastomosis.展开更多
Objective: To investigate the effect of severe heatstroke on coagulation function in rats and the possible mechanism of high-mobility group protein B1(HMGB1)involved in the regulation of coagulation function. Methods:...Objective: To investigate the effect of severe heatstroke on coagulation function in rats and the possible mechanism of high-mobility group protein B1(HMGB1)involved in the regulation of coagulation function. Methods: A total of 24 male SD rats were randomly divided into control group, mild group, moderate group and severe group,with 6 rats in each group. The rats in mild group, moderate group and severe group were continuously exposed to 40℃ and 10% humidity environment, then taken out and rewarmed to complete the heat stroke rat modeling process after the experiments were conducted for 70, 110, and 145 min, respectively. The levels of HMGB1 in peripheral blood were detected by enzyme-linked immunosorbent assay(ELISA) before modeling and at 0 and 3 h after modeling, and coagulation tests were used to determine prothrombin time(PT), activated partial thromboplastin time(APTT), and prothrombin time(APT) at the same time points in the rats. The correlation between HMGB1 and coagulation parameters was determined by Pearson correlation. Results: In the severe group, HMGB1 was(2372.45±97.85) pg/ml and(2547.72±117.67) pg/ml at 0 and 3 h after modeling, respectively, and the levels of PT, APTT and Fib were higher than those before modeling and at 3 h after modeling. There was significant correlation between HMGBI and APTT, Fib(r=0.978, 0.785, P=0.000, 0.000). There were positive correlations between HMGBI and PT, APTT, Fib(r=0.634,0.976,0.889, P=0.001,0.000,0.000).Conclusion: HMGB1 may be involved in the pathogenesis of coagulation dysfunction in rats with severe heatstroke by regulating the activation of coagulation cells, and the level of HMGB1 in rats with severe heatstroke increases and still tends to increase after rewarming.展开更多
Background Renal insufficiency is associated with an excess risk of vascular complications and bleeding events in patients who undergo PCI. Heparin is still used commonly for PCI, but the bleeding complications is hig...Background Renal insufficiency is associated with an excess risk of vascular complications and bleeding events in patients who undergo PCI. Heparin is still used commonly for PCI, but the bleeding complications is high. However, Bivalirudin is similar to heparin in ischemic complications and superior to the bleeding complications. Methods A total of 181 patients with coronary artery disease and renal insufficiency were randomly assigned two treatment groups: Bivalirudin(n = 90), unfractionated heparin(n = 91). Activated clotting time(ACT)was determined in patients at 5 min after undergoing PCI at the end of operation immediately(stopping drug immediately), and 30 min,1 h, 2 h after stopping drug. Activated partial thromboplastin time(APTT), thrombin time(TT), proth rombin time(PT), fibrinogen(FIB) index were measured before treatment, 6 h, 24 h and 72 h after the treatment through an automated coagulation analyzer. Platelet count was monitored before treatment and24 h after treatment. The end points were the proportion of net adverse clinical events(NACE)and stent thrombosis at 30 days. Results The use of bivalirudin was associated with a statistically significant higher at 5 min after treatment, end of operation immediately(P < 0.05),with statistically significant lower at 1h after stopping drug, 2h after stopping drug(P < 0.05). There were no differences between patients at blood coagulation and platelet after operation(P > 0.05), no differences in the 30-day rates of stent thrombosis(0% vs. 0%, P = 1). Eleven patients(12.22%) treated with bivalirudin vs. 24(26.38%) treated with heparin experienced an adverse clinical events at 30 days(relative risk[RR], 0.46; 95%CI, 0.36-0.56; P < 0.025). There were no differences in the major adverse cardiac or cerebral event at the 30-day end point(1.11% vs. 2.20%, P > 0.05). The bleeding at 30 days was abated by using bivalirudin compared with unfractionated heparin(11.11% vs. 24.18%, P < 0.05). Conclusions Compared with the unfractionated heparin, bivalirudin is more quickly in taking effect and recovering and more efficient for PCI in patients with coronary artery disease and renal insufficiency.展开更多
Background:Sepsis-induced coagulopathy and multiple organ dysfunction syndromes are the leading causes of death in patients with sepsis.Qingwen Baidu decoction(QWBD)can effectively improve the clinical manifestations ...Background:Sepsis-induced coagulopathy and multiple organ dysfunction syndromes are the leading causes of death in patients with sepsis.Qingwen Baidu decoction(QWBD)can effectively improve the clinical manifestations of sepsis and ease inflammation,but its effects on coagulation functions and multiple organ injuries remain unclear.Methods:100 healthy,male Sprague-Dawley rats were randomly divided into the sham group,the cecal ligation and puncture(CLP)group,the low-dose QWBD group,and the high-dose QWBD group,with 25 rats in each group.The sepsis model was established using CLP.Blood was collected to measure platelet count,serum creatinine(Cr),blood urea nitrogen(BUN),alanine aminotransferase(ALT),and aspartate aminotransferase(AST)levels,as well as coagulation function.The total protein in bronchoalveolar lavage fluid(BALF)was determined in each group of rats.The lung,liver,and kidney tissues were harvested,and statistics were calculated on the wet-to-dry(W/D)weight ratio.Changes in histopathology and thrombin level were evaluated in each group.The remaining ten rats in each group were observed daily to record the number of surviving rats.Such observation was made consecutively for 7 days to calculate survival rates.Results:After model establishment,ALT,AST,Cr,and BUN levels were significantly elevated(P<0.01).The BALF protein content and lung W/D weight ratio were significantly increased(P<0.01).Furthermore,the survival rate of rats was significantly reduced in the CLP group compared with the sham group.After the treatment,rats in the high-dose QWBD group had lower ALT(P<0.05),AST(P<0.01),Cr(P<0.05),BUN(P<0.01)levels,lower BALF protein content(P<0.05)and lower lung W/D weight ratio(P<0.01)than the CLP group.However,rats in the high-dose QWBD group had significantly better pathological changes in the lung,liver,and kidney compared to the sham group.After the treatment,the platelet level in the peripheral blood was elevated(P<0.05)and both activated partial thromboplastin time and prothrombin time were significantly shortened(P<0.01).The fibrinogen level was significantly increased(P<0.01).Finally,thrombin positive expression areas in the lung,liver,and kidney were significantly decreased in the high-dose QWBD group.Conclusion:QWBD can improve coagulation disorders caused by sepsis and has a protective effect on multiple organ injuries in rats.展开更多
Colorectal Cancer (CRC) is a common malignant tumour of the gastrointestinal tract in China, with increasing morbidity and mortality rates year by year. Most patients are in the middle and late stage when diagnosed, a...Colorectal Cancer (CRC) is a common malignant tumour of the gastrointestinal tract in China, with increasing morbidity and mortality rates year by year. Most patients are in the middle and late stage when diagnosed, and its high mortality and poor prognosis have seriously threatened the health and life. Fibrinogen (FIB) is mainly used as a coagulation factor in the body to participate in the process of coagulation and haemostasis, and is the main protein in the coagulation process. In recent years, studies at home and abroad have shown that FIB levels correlate with the diagnosis, outcome prediction and prognosis of CRC, and some of the findings are still controversial. This article aims to review the related research and new progress of the relationship between FIB and CRC in recent years.展开更多
BACKGROUND Multiple myeloma patients usually present with CRAB symptoms(hypercalcemia,renal disease,anemia and bone diseases)as initial manifestations.Bleeding symptoms are less common,most of which result from thromb...BACKGROUND Multiple myeloma patients usually present with CRAB symptoms(hypercalcemia,renal disease,anemia and bone diseases)as initial manifestations.Bleeding symptoms are less common,most of which result from thrombocytopenia or infiltration of plasmacytoma.Relatively,coagulopathy is not so common,especially isolated coagulopathy without CRAB manifestations,which is very rare.Herein,we report a 54-year old female who was hospitalized for intermittent and recurrent mild oral mucosal hemorrhage without other bleeding symptoms for almost one month or typical myeloma features.CASE SUMMARY Two months before admission,the patient underwent implantation of a permanent pacemaker due to sick sinus syndrome.Prothrombin time and activated partial thromboplastin time were significantly prolonged.Factor X deficiency was demonstrated to account for the coagulation dysfunction.An M protein peak was shown by serum protein electrophoresis.26.11%of abnormal plasma cells were detected in bone marrow by flow cytometry,expressing CD38,CD138,CD56 and intracellular immunoglobulin Kappa light chain.Bone marrow biopsy also proved the presence of abnormal plasma cells,but Congo red stain was negative.The patient was finally diagnosed with multiple myeloma IgA-κtype.A literature review indicated that factor X deficiency was highly related to amyloidosis.Before bleeding signs,the patient had cardiac arrhythmia,enlargement of the heart,and progressive heart failure;thus,cardiac amyloidosis was suspected.CONCLUSION Bleeding related to coagulation dysfunction is uncommon in multiple myeloma,especially as the initial manifestation.Amyloidosis is a well-recognized cause of isolated acquired factor X deficiency.展开更多
BACKGROUND Obstetric hemorrhage is the leading cause of maternal mortality globally,especially in China.The key to a successful rescue is immediate and rapid blood transfusion.Autotransfusion has become an integral pa...BACKGROUND Obstetric hemorrhage is the leading cause of maternal mortality globally,especially in China.The key to a successful rescue is immediate and rapid blood transfusion.Autotransfusion has become an integral part of clinical blood transfusion,with intraoperative cell salvage(IOCS)being the most widely used.AIM To investigate the application of IOCS in cesarean section.METHODS A total of 87 patients who underwent cesarean section and blood transfusion in our hospital from March 2015 to June 2020 were included in this prospective controlled study.They were divided into the observation(43 cases)and control(44 cases)groups using the random number table method.The patients in both groups underwent lower-segment cesarean section.The patients in the control group were treated with traditional allogeneic blood transfusion,whereas those in the observation group were treated with IOCS.Hemorheology[Red blood cell count,platelet volume,and fibrinogen(FIB)]and coagulation function(partial prothrombin time,prothrombin time(PT),platelet count,and activated coagulation time)were measured before and 24 h after transfusion.In the two groups,adverse reactions,such as choking and dyspnea,within 2 h after cesarean section were observed.RESULTS Before and after transfusion,no significant differences in hemorheology and coagulation function indices between the two groups were observed(P>0.05).About 24 h after transfusion,the erythrocyte count,platelet ratio,and FIB value significantly decreased in the two groups(P<0.05);the PLT value significantly decreased in the two groups;the activated partial thromboplastin time,PT,and activated clotting time significantly increased in the two groups(P<0.05);and no statistical differences were observed in hemorheology and coagulation function indices between the two groups(P>0.05).Furthermore,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).CONCLUSION In patients undergoing cesarean section,intraoperative cell salvage has a minimum effect on hemorheology and coagulation function and does not increase the risk of amniotic fluid embolism.展开更多
We here aimed to investigate the impact of gender on the clinical characteristics and laboratory results of patients with coronavirus disease 2019(COVID-19)and provide clues to the pathological mechanisms underlying C...We here aimed to investigate the impact of gender on the clinical characteristics and laboratory results of patients with coronavirus disease 2019(COVID-19)and provide clues to the pathological mechanisms underlying COVID-19.A retrospective study was performed.Clinical characteristics,severity of lung infection,laboratory results,and prognoses of patients of different gender were analyzed.A total of 242 patients were finally included.The median age was 58 years(IQR:40-68),including 54(22.3%)hospital staffs.Ninety-four(38.8%)were male and 148(61.1%)were female.The proportion of patients with diabetes was significantly higher in the male group than in the female group(P=0.034).Male patients had a significantly larger proportion of severe lung infection,higher leukocyte count,neutrophil count,neutrophil-to-lymphocyte ratio,C-reactive protein,and procalcitonin than femalc.Furthermore,male patients had worse liver,cardiac,and coagulation function than their female counterparts.Male patients with COVID-19 showed more severe inflammation reaction and coagulation dysfunction than female patients.In conclusion,gender is associated with host response to SARS-CoV-2 infection.展开更多
Pregnancy with solid pseudopapillary tumor of the pancreas(SPTP)is rare.Because pregnancy hormones may cause tumor progression,the management and treatment of SPTP need to balance the safety of pregnant women and fetu...Pregnancy with solid pseudopapillary tumor of the pancreas(SPTP)is rare.Because pregnancy hormones may cause tumor progression,the management and treatment of SPTP need to balance the safety of pregnant women and fetuses with surgical treatment.We reported a case of a giant pancreatic tumor diagnosed during pregnancy that was considered to be SPTP.Examinations also showed hepatitis B virus infection and severe decompensation of liver cirrhosis.Medical termination of pregnancy was performed.The patient has lived with the tumor until now without surgery.We retrieved the published case reports,summarized the clinical characteristics of pregnancy with SPTP,and explored its management during the perinatal period.Most patients with SPTP have a good prognosis with good maternal and fetal outcomes,and it is important to choose an appropriate treatment method and timing.However,pregnancy combined with decompensated liver cirrhosis needs to be terminated in a timely manner because of its high-risk status.展开更多
Hydroxyethy/ starch (HES) 130/0.4 is a novel HES solution for intravenous administration. Compared with previous HES solutions, it possesses better capacity effect, with minor adverse effects on coagulation train, tea...Hydroxyethy/ starch (HES) 130/0.4 is a novel HES solution for intravenous administration. Compared with previous HES solutions, it possesses better capacity effect, with minor adverse effects on coagulation train, teair and kidney functions. Incidence of hypersensitivity in relation with HES 130/0.4 is very low, At it’s quite safe in clinical use.展开更多
基金Major Project of Shanghai Science and Technology Commission (Sub-project) No: 11411950300
文摘Objective: To investigate the effects of butyphthalide + alteplase (rt-PA) intravenous thrombolysis on the diffusion-weighted imaging (DWI) characteristics, coagulation function and neurological function in patients with acute cerebral infarction. Methods: The patients with acute cerebral infarction who were admitted to our hospital between April 2015 and October 2018 and with the onset time 4.5 hours were selected and divided into the observation group receiving butyphthalide + rt-PA intravenous thrombolysis and the control group receiving rt-PA intravenous thrombolysis by random number table. The differences in DWI parameter apparent diffusion coefficient (ADC), coagulation function indexes and neurological function indexes were compared between the two groups. Results: At 7 and 14 days after treatment, the ADC values of both groups were significantly increased, and the ADC values of the observation group were significantly higher than those of the control group;at 7 days after treatment, the prothrombin time (PT) and activated partial thromboplastin time (APTT) levels in both groups were significantly prolonged whereas fibrinogen (FIB), D-dimer (D-D), platelet activating factor (PAF), P-selectin, von Willebrand factor (vWF), neuron-specific enolase (NSE), S100B protein (S100B), malondialdehyde (MDA) and endothelin-1 (ET-1) contents were significantly decreased, and the APTT and PT levels in the observation group were significantly shorter than those in the control group whereas FIB, D-D, PAF, P-selectin, vWF, NSE, S100B, MDA and ET-1 contents were significantly lower than those in the control group. Conclusion: Butyphthalide + rt-PA intravenous thrombolysis can improve the DWI characteristics, coagulation function and neurological function of patients with acute cerebral infarction.
文摘Objective:To investigate the effects of intravenous thrombolysis therapy with alteplase on neurological function,coagulation function and serum inflammatory factors in patients with acute cerebral infarction.Methods:A total of 96 patients with acute cerebral infarction admitted to our hospital from September 2017 to October 2019 were randomly divided into two groups,with 48 patients in each group.The control group(n=48)received routine treatment,and the observation group received intravenous thrombolysis therapy with alteplase on the basis of routine treatment.The neurological deficit score,prothrombin time(PT),activated partial thromboplastin time(APTT),tumor necrosis factor-a level(TNF-α),and high-sensitivity C-reactive protein(hs-CRP)were compared between the two groups after 15 days of treatment.Results:After treatment,NIHSS scores in both groups were lower than those before treatment;PT levels were increased,while APTT,TNF-αand hs-CRP levels were all decreased in both groups,and the changes in the observation group were greater than those in the control group,with statistically significant difference(P<0.05).Conclusions:Intravenous thrombolysis therapy with alteplase can improve the neurological function,coagulation function and serum levels of inflammatory factors in patients with acute cerebral infarction,which is worthy of clinical application.
基金Yingtan City Science and Technology Project(No.YKz20180033)
文摘Objective:To investigate the effects of sevoflurane inhalation general anesthesia on serum IL-6,brain injury protein S100βand coagulation function in elderly patients undergoing total hip arthroplasty.Method:From May 2017 to May 2019,84 patients,age 60-75 underwent total hip arthroplasty in our hospital.were randomly divided into two groups:group A(n=42)and group B(n=42).Group A was maintained with sevoflurane inhalation by general anesthesia and group B with propofol by intravenous anesthesia.The surgical related indexes and postoperative complications in the two groups were compared.The level of serum IL-6,S100β,Coagulation function index[platelet count(PLT),Fibrinogen(FIB),plasma D-dimer(D-D),activated partial enzyme activity time(APTT),prothrombin time(PT)],MMSE score and MoCA score were compared between two groups before and after operation.Results:There was no significant difference in anesthesia time,operation time,intraoperative bleeding and postoperative drainage(P>0.05).1h,1d and 7d after operation,the level of PLT,D-D and FIB in group A were significantly lower than that in group B(P<0.05),PT and APTT were significantly higher than that in group B(P<0.05).1h,1d and 7d after operation,the level of IL-6,S100βin group A were significantly lower than that in group B(P<0.05).1d after operation,the MMSE and MoCA scores in group B were significantly lower than those in group A(P<0.05).The incidence of lower extremity deep venous thrombosis(2.38%)and cognitive impairment(2.38%)in group A was lower than that in group B(14.29%,16.67%)(t1=3.896,P1=0.048;t2=4.974,P2=0.026).Conclusion:sevoflurane anesthesia can reduce the incidence of deep venous thrombosis and cognitive impairment of the lower extremity after operation in elderly patients with thr,stabilize the coagulation index of patients,and downregulate the expression of il-6 and S100β.
文摘Objective:To observe the effect of Taohong Siyu Decoction on the coagulation function and the signaling pathway of PI3K(phosphatidylinositol 3-kinase)/AKT(protein kinase B)/mTOR(mammalian target of rapamycin)after femoral artery anastomosis in rabbits.Methods:30 New Zealand white rabbits were divided into blank control group,model control group,papavine hydrochloride injection group and low,medium and high dose groups of Taohong Siwu decoction by random number table method,with 5 rabbits in each group.The rabbits in the model control group,papavine hydrochloride injection group and low,medium and high dose groups of Taohong Siwu decoction were treated with the femoral artery simple intermittent end-to-end suture model.After the successful modeling,the low,medium and high dose groups of Taohong Siwu decoction were given the Taohong Siwu decoction,while the model control group,the blank control group and papavine hydrochloride injection group were given the same amount of normal saline.APTT(activated partial thromboplastin time),FIB(fibrinogen)and PI3K/AKT/mTOR concentrations were measured in aural venous blood samples from six groups of rabbits 30min before operation and 1d,2D,3D and 7d after operation,respectively.Statistical analysis was conducted on the data of the six groups.Results:Compared with blank control group,APTT of model control group was significantly shortened 1d to 7d after operation(P<0.05),FIB values were significantly increased from 1d to 7d after operation(P<0.05);Compared with model control group,APTT in Taohong Siwu decoction low-dose,medium-dose and high-dose groups were significantly prolonged 1d to 7d after operation(P<0.05),FIB value of Taohong Siwu decoction medium and high dose groups decreased significantly from 1d to 7d after operation(P<0.05),the FIB value of Taohong Siwu decoction low-dose group was significantly decreased from 2d to 7d after surgery(P<0.05);Compared with papaverine hydrochloride injection group,APTT in Taohong Siwu decoction medium dose group was significantly prolonged 2d to 7d after surgery(P<0.05),APTT of Taohong Siwu decoction high-dose group was significantly prolonged on 1d to 7d after operation(P<0.05).FIB in Taohong Siwu decoction medium and high dose groups decreased significantly 1d to 7d after operation(P<0.05);Compared with the blank control group,the expression concentrations of PI3K,Akt and mTOR in serum of the model control group were significantly increased from 1d to 7d after surgery(P<0.05);Compared with the model control group,the expression levels of PI3K,Akt and mTOR in serum were significantly increased in the low dose group of Taohong Siwu decoction and Papaverine Hydrochloride Injection group on postoperative 7 days(P<0.05),Taohong Siwu decoction high-dose group was significantly increased from 1d to 7d after surgery(P<0.05),the expression concentrations of PI3K and Akt in Taohong Siwu decoction medium dose group were significantly increased from 2d to 7d after operation(P<0.05),mTOR expression levels were significantly increased from 3d to 7d after operation(P<0.05);Compared with papaverine hydrochloride injection group,the expression concentrations of PI3K,Akt and mTOR in serum of Taohong Siwu decoction medium dose group were significantly increased from 3d to 7d after operation(P<0.05),the expression concentrations of PI3K and mTOR in Taohong Siwu decoction high-dose group were significantly increased from 1d to 7d after operation(P<0.05),and the expression concentration of Akt increased significantly from 3d to 7d after operation(P<0.05).Conclusion:The Taohong Siwu decoction can improve the coagulation function of rabbit femoral artery anastomosis,prevent thrombosis,activate PI3K/Akt/mTOR signaling pathway,promote angiogenesis,and improve tissue ischemia after artery anastomosis.
文摘Objective: To investigate the effect of severe heatstroke on coagulation function in rats and the possible mechanism of high-mobility group protein B1(HMGB1)involved in the regulation of coagulation function. Methods: A total of 24 male SD rats were randomly divided into control group, mild group, moderate group and severe group,with 6 rats in each group. The rats in mild group, moderate group and severe group were continuously exposed to 40℃ and 10% humidity environment, then taken out and rewarmed to complete the heat stroke rat modeling process after the experiments were conducted for 70, 110, and 145 min, respectively. The levels of HMGB1 in peripheral blood were detected by enzyme-linked immunosorbent assay(ELISA) before modeling and at 0 and 3 h after modeling, and coagulation tests were used to determine prothrombin time(PT), activated partial thromboplastin time(APTT), and prothrombin time(APT) at the same time points in the rats. The correlation between HMGB1 and coagulation parameters was determined by Pearson correlation. Results: In the severe group, HMGB1 was(2372.45±97.85) pg/ml and(2547.72±117.67) pg/ml at 0 and 3 h after modeling, respectively, and the levels of PT, APTT and Fib were higher than those before modeling and at 3 h after modeling. There was significant correlation between HMGBI and APTT, Fib(r=0.978, 0.785, P=0.000, 0.000). There were positive correlations between HMGBI and PT, APTT, Fib(r=0.634,0.976,0.889, P=0.001,0.000,0.000).Conclusion: HMGB1 may be involved in the pathogenesis of coagulation dysfunction in rats with severe heatstroke by regulating the activation of coagulation cells, and the level of HMGB1 in rats with severe heatstroke increases and still tends to increase after rewarming.
文摘Background Renal insufficiency is associated with an excess risk of vascular complications and bleeding events in patients who undergo PCI. Heparin is still used commonly for PCI, but the bleeding complications is high. However, Bivalirudin is similar to heparin in ischemic complications and superior to the bleeding complications. Methods A total of 181 patients with coronary artery disease and renal insufficiency were randomly assigned two treatment groups: Bivalirudin(n = 90), unfractionated heparin(n = 91). Activated clotting time(ACT)was determined in patients at 5 min after undergoing PCI at the end of operation immediately(stopping drug immediately), and 30 min,1 h, 2 h after stopping drug. Activated partial thromboplastin time(APTT), thrombin time(TT), proth rombin time(PT), fibrinogen(FIB) index were measured before treatment, 6 h, 24 h and 72 h after the treatment through an automated coagulation analyzer. Platelet count was monitored before treatment and24 h after treatment. The end points were the proportion of net adverse clinical events(NACE)and stent thrombosis at 30 days. Results The use of bivalirudin was associated with a statistically significant higher at 5 min after treatment, end of operation immediately(P < 0.05),with statistically significant lower at 1h after stopping drug, 2h after stopping drug(P < 0.05). There were no differences between patients at blood coagulation and platelet after operation(P > 0.05), no differences in the 30-day rates of stent thrombosis(0% vs. 0%, P = 1). Eleven patients(12.22%) treated with bivalirudin vs. 24(26.38%) treated with heparin experienced an adverse clinical events at 30 days(relative risk[RR], 0.46; 95%CI, 0.36-0.56; P < 0.025). There were no differences in the major adverse cardiac or cerebral event at the 30-day end point(1.11% vs. 2.20%, P > 0.05). The bleeding at 30 days was abated by using bivalirudin compared with unfractionated heparin(11.11% vs. 24.18%, P < 0.05). Conclusions Compared with the unfractionated heparin, bivalirudin is more quickly in taking effect and recovering and more efficient for PCI in patients with coronary artery disease and renal insufficiency.
基金supported by the National Key R&D Program of China(No.2018YFC1706500Nos.81973800)+3 种基金the Tianjin Scientific Research Project of Priority Area of Traditional Chinese Medicine(No.20170062022007)the Oncology Translational Medicine Seed Fund Project of Tianjin Medical University Cancer Hospital(No.1910)the Chunmiao Project of Tianjin First Center Hospital(No.2019CM15).
文摘Background:Sepsis-induced coagulopathy and multiple organ dysfunction syndromes are the leading causes of death in patients with sepsis.Qingwen Baidu decoction(QWBD)can effectively improve the clinical manifestations of sepsis and ease inflammation,but its effects on coagulation functions and multiple organ injuries remain unclear.Methods:100 healthy,male Sprague-Dawley rats were randomly divided into the sham group,the cecal ligation and puncture(CLP)group,the low-dose QWBD group,and the high-dose QWBD group,with 25 rats in each group.The sepsis model was established using CLP.Blood was collected to measure platelet count,serum creatinine(Cr),blood urea nitrogen(BUN),alanine aminotransferase(ALT),and aspartate aminotransferase(AST)levels,as well as coagulation function.The total protein in bronchoalveolar lavage fluid(BALF)was determined in each group of rats.The lung,liver,and kidney tissues were harvested,and statistics were calculated on the wet-to-dry(W/D)weight ratio.Changes in histopathology and thrombin level were evaluated in each group.The remaining ten rats in each group were observed daily to record the number of surviving rats.Such observation was made consecutively for 7 days to calculate survival rates.Results:After model establishment,ALT,AST,Cr,and BUN levels were significantly elevated(P<0.01).The BALF protein content and lung W/D weight ratio were significantly increased(P<0.01).Furthermore,the survival rate of rats was significantly reduced in the CLP group compared with the sham group.After the treatment,rats in the high-dose QWBD group had lower ALT(P<0.05),AST(P<0.01),Cr(P<0.05),BUN(P<0.01)levels,lower BALF protein content(P<0.05)and lower lung W/D weight ratio(P<0.01)than the CLP group.However,rats in the high-dose QWBD group had significantly better pathological changes in the lung,liver,and kidney compared to the sham group.After the treatment,the platelet level in the peripheral blood was elevated(P<0.05)and both activated partial thromboplastin time and prothrombin time were significantly shortened(P<0.01).The fibrinogen level was significantly increased(P<0.01).Finally,thrombin positive expression areas in the lung,liver,and kidney were significantly decreased in the high-dose QWBD group.Conclusion:QWBD can improve coagulation disorders caused by sepsis and has a protective effect on multiple organ injuries in rats.
文摘Colorectal Cancer (CRC) is a common malignant tumour of the gastrointestinal tract in China, with increasing morbidity and mortality rates year by year. Most patients are in the middle and late stage when diagnosed, and its high mortality and poor prognosis have seriously threatened the health and life. Fibrinogen (FIB) is mainly used as a coagulation factor in the body to participate in the process of coagulation and haemostasis, and is the main protein in the coagulation process. In recent years, studies at home and abroad have shown that FIB levels correlate with the diagnosis, outcome prediction and prognosis of CRC, and some of the findings are still controversial. This article aims to review the related research and new progress of the relationship between FIB and CRC in recent years.
文摘BACKGROUND Multiple myeloma patients usually present with CRAB symptoms(hypercalcemia,renal disease,anemia and bone diseases)as initial manifestations.Bleeding symptoms are less common,most of which result from thrombocytopenia or infiltration of plasmacytoma.Relatively,coagulopathy is not so common,especially isolated coagulopathy without CRAB manifestations,which is very rare.Herein,we report a 54-year old female who was hospitalized for intermittent and recurrent mild oral mucosal hemorrhage without other bleeding symptoms for almost one month or typical myeloma features.CASE SUMMARY Two months before admission,the patient underwent implantation of a permanent pacemaker due to sick sinus syndrome.Prothrombin time and activated partial thromboplastin time were significantly prolonged.Factor X deficiency was demonstrated to account for the coagulation dysfunction.An M protein peak was shown by serum protein electrophoresis.26.11%of abnormal plasma cells were detected in bone marrow by flow cytometry,expressing CD38,CD138,CD56 and intracellular immunoglobulin Kappa light chain.Bone marrow biopsy also proved the presence of abnormal plasma cells,but Congo red stain was negative.The patient was finally diagnosed with multiple myeloma IgA-κtype.A literature review indicated that factor X deficiency was highly related to amyloidosis.Before bleeding signs,the patient had cardiac arrhythmia,enlargement of the heart,and progressive heart failure;thus,cardiac amyloidosis was suspected.CONCLUSION Bleeding related to coagulation dysfunction is uncommon in multiple myeloma,especially as the initial manifestation.Amyloidosis is a well-recognized cause of isolated acquired factor X deficiency.
文摘BACKGROUND Obstetric hemorrhage is the leading cause of maternal mortality globally,especially in China.The key to a successful rescue is immediate and rapid blood transfusion.Autotransfusion has become an integral part of clinical blood transfusion,with intraoperative cell salvage(IOCS)being the most widely used.AIM To investigate the application of IOCS in cesarean section.METHODS A total of 87 patients who underwent cesarean section and blood transfusion in our hospital from March 2015 to June 2020 were included in this prospective controlled study.They were divided into the observation(43 cases)and control(44 cases)groups using the random number table method.The patients in both groups underwent lower-segment cesarean section.The patients in the control group were treated with traditional allogeneic blood transfusion,whereas those in the observation group were treated with IOCS.Hemorheology[Red blood cell count,platelet volume,and fibrinogen(FIB)]and coagulation function(partial prothrombin time,prothrombin time(PT),platelet count,and activated coagulation time)were measured before and 24 h after transfusion.In the two groups,adverse reactions,such as choking and dyspnea,within 2 h after cesarean section were observed.RESULTS Before and after transfusion,no significant differences in hemorheology and coagulation function indices between the two groups were observed(P>0.05).About 24 h after transfusion,the erythrocyte count,platelet ratio,and FIB value significantly decreased in the two groups(P<0.05);the PLT value significantly decreased in the two groups;the activated partial thromboplastin time,PT,and activated clotting time significantly increased in the two groups(P<0.05);and no statistical differences were observed in hemorheology and coagulation function indices between the two groups(P>0.05).Furthermore,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).CONCLUSION In patients undergoing cesarean section,intraoperative cell salvage has a minimum effect on hemorheology and coagulation function and does not increase the risk of amniotic fluid embolism.
基金supported by the National Natural Science Foundation of China(Nos.81570416,81570337)Hubei Province Health and Family Planning Scientifie Research Project(No.WJ2019M120)+3 种基金Natural Science Foundation of Hubei Province(No.2019CFB668)the Fundamental Research Fund for the Central Universities(HUST)(No.2017KFYXJJ099)the Science and Technology Project Foundation of Wuhan(No.2017060201010175)the Outstanding Young Investigator Foundation of Tongji Hospital(No.YXQN009)。
文摘We here aimed to investigate the impact of gender on the clinical characteristics and laboratory results of patients with coronavirus disease 2019(COVID-19)and provide clues to the pathological mechanisms underlying COVID-19.A retrospective study was performed.Clinical characteristics,severity of lung infection,laboratory results,and prognoses of patients of different gender were analyzed.A total of 242 patients were finally included.The median age was 58 years(IQR:40-68),including 54(22.3%)hospital staffs.Ninety-four(38.8%)were male and 148(61.1%)were female.The proportion of patients with diabetes was significantly higher in the male group than in the female group(P=0.034).Male patients had a significantly larger proportion of severe lung infection,higher leukocyte count,neutrophil count,neutrophil-to-lymphocyte ratio,C-reactive protein,and procalcitonin than femalc.Furthermore,male patients had worse liver,cardiac,and coagulation function than their female counterparts.Male patients with COVID-19 showed more severe inflammation reaction and coagulation dysfunction than female patients.In conclusion,gender is associated with host response to SARS-CoV-2 infection.
基金supported by the National Key R&D Program of China (grant no.2019YFC1005105).
文摘Pregnancy with solid pseudopapillary tumor of the pancreas(SPTP)is rare.Because pregnancy hormones may cause tumor progression,the management and treatment of SPTP need to balance the safety of pregnant women and fetuses with surgical treatment.We reported a case of a giant pancreatic tumor diagnosed during pregnancy that was considered to be SPTP.Examinations also showed hepatitis B virus infection and severe decompensation of liver cirrhosis.Medical termination of pregnancy was performed.The patient has lived with the tumor until now without surgery.We retrieved the published case reports,summarized the clinical characteristics of pregnancy with SPTP,and explored its management during the perinatal period.Most patients with SPTP have a good prognosis with good maternal and fetal outcomes,and it is important to choose an appropriate treatment method and timing.However,pregnancy combined with decompensated liver cirrhosis needs to be terminated in a timely manner because of its high-risk status.
文摘Hydroxyethy/ starch (HES) 130/0.4 is a novel HES solution for intravenous administration. Compared with previous HES solutions, it possesses better capacity effect, with minor adverse effects on coagulation train, teair and kidney functions. Incidence of hypersensitivity in relation with HES 130/0.4 is very low, At it’s quite safe in clinical use.
