Objective Coagulation abnormalities are common and prognostically significant in intensive care units(ICUs)and are associated with increased mortality.This study aimed to explore the association between the levels of ...Objective Coagulation abnormalities are common and prognostically significant in intensive care units(ICUs)and are associated with increased mortality.This study aimed to explore the association between the levels of coagulation markers and the risk of mortality among ICU patients with coagulation abnormalities.Methods This retrospective study investigated patients with coagulation abnormalities in the ICU between January 2021 and December 2022.The initial point for detecting hemostatic biomarkers due to clinical assessment of coagulation abnormalities was designated day 0.Patients were followed up for 28 days,and multivariate logistic regression analysis was utilized to identify risk factors for mortality.Results Of the 451 patients analyzed,115 died,and 336 were alive at the end of the 28-day period.Multivariate analysis revealed that elevated thrombin-antithrombin complex(TAT),tissue plasminogen activator inhibitor complex(tPAIC),prolonged prothrombin time,and thrombocytopenia were independent risk factors for mortality.For nonovert disseminated intravascular coagulation(DIC)patients,older age and thrombocytopenia were associated with increased risks of mortality,whereas elevated levels of plasminα2-plasmin inhibitor complex(PIC)were found to be independent predictors of survival.In patients with overt DIC,elevated levels of tPAIC were independently associated with increased risks of mortality.Nevertheless,thrombocytopenia was independently associated with increased risks of mortality in patients with pre-DIC.Conclusion Coagulation markers such as the TAT,tPAIC,PIC,and platelet count were significantly associated with mortality,underscoring the importance of maintaining a balance between coagulation and fibrinolysis.These findings highlight the potential for targeted therapeutic interventions based on specific coagulation markers to improve patient outcomes.展开更多
BACKGROUND:Disseminated intravascular coagulation(DIC)is associated with increased mortality in sepsis patients.In this study,we aimed to assess the clinical ability of sepsis-induced coagulopathy(SIC)and sepsis-assoc...BACKGROUND:Disseminated intravascular coagulation(DIC)is associated with increased mortality in sepsis patients.In this study,we aimed to assess the clinical ability of sepsis-induced coagulopathy(SIC)and sepsis-associated coagulopathy(SAC)criteria in identifying overt-DIC and preDIC status in sepsis patients.METHODS:Data from 419 sepsis patients were retrospectively collected from July 2018 to December 2022.The performances of the SIC and SAC were assessed to identify overt-DIC on days 1,3,7,or 14.The SIC status or SIC score on day 1,the SAC status or SAC score on day 1,and the sum of the SIC or SAC scores on days 1 and 3 were compared in terms of their ability to identify pre-DIC.The SIC or SAC status on day 1 was evaluated as a pre-DIC indicator for anticoagulant initiation.RESULTS:On day 1,the incidences of coagulopathy according to overt-DIC,SIC and SAC criteria were 11.7%,22.0%and 31.5%,respectively.The specificity of SIC for identifying overt-DIC was significantly higher than that of the SAC criteria from day 1 to day 14(P<0.05).On day 1,the SIC score with a cut-off value>3 had a significantly higher sensitivity(72.00%)and area under the curve(AUC)(0.69)in identifying pre-DIC than did the SIC or SAC status(sensitivity:SIC status 44.00%,SAC status 52.00%;AUC:SIC status 0.62,SAC status 0.61).The sum of the SIC scores on days 1 and 3 had a higher AUC value for identifying the pre-DIC state than that of SAC(0.79 vs.0.69,P<0.001).Favorable effects of anticoagulant therapy were observed in SIC(adjusted hazard ratio[HR]=0.216,95%confidence interval[95%CI]:0.060–0.783,P=0.018)and SAC(adjusted HR=0.146,95%CI:0.041–0.513,P=0.003).CONCLUSION:The SIC and SAC seem to be valuable for predicting overt-DIC.The sum of SIC scores on days 1 and 3 has the potential to help identify pre-DIC.展开更多
BACKGROUND The incidence of Barrett’s esophagus(BE)in China is lower compared to the Western populations.Hence,studies conducted in the Chinese population has been limited.The current treatment options available for ...BACKGROUND The incidence of Barrett’s esophagus(BE)in China is lower compared to the Western populations.Hence,studies conducted in the Chinese population has been limited.The current treatment options available for BE treatment includes argon plasma coagulation(APC),radiofrequency ablation and cryoablation,all with varying degrees of success.AIM To determine the efficacy and safety of HybridAPC in the treatment of BE.METHODS The study cohort consisted of patients with BE who underwent HybridAPC ablation treatment.These procedures were performed by seven endoscopists from different tertiary hospitals.The duration of the procedure,curative rate,complications and recurrent rate by 1-year follow-up were recorded.RESULTS Eighty individuals were enrolled for treatment from July 2017 to June 2020,comprising of 39 males and 41 females with a median age of 54 years(range,30 to 83 years).The technical success rate of HybridAPC was 100%and the overall curative rate was 98.15%.No severe complications occurred during the operation.BE cases were classified as short-segment BE and long-segment BE.Patients with short-segment BE were all considered cured without complications.Thirty-six patients completed the one-year follow-up without recurrence.Twenty-four percent had mild dysplasia which were all resolved with one post-procedural treatment.The mean duration of the procedure was 10.94±6.52 min.CONCLUSION Treatment of BE with HybridAPC was found to be a simple and quick procedure that is safe and effective during the short-term follow-up,especially in cases of short-segment BE.This technique could be considered as a feasible alternative ablation therapy for BE.展开更多
Fluid catalytic cracking (FCC) salty wastewaters, containing quaternary ammonium compounds (QACs), are very difficult to treat by biochemical process. Anoxic/oxic (A/O) biochemical system, based on nitrification and d...Fluid catalytic cracking (FCC) salty wastewaters, containing quaternary ammonium compounds (QACs), are very difficult to treat by biochemical process. Anoxic/oxic (A/O) biochemical system, based on nitrification and denitrification reactions, was used to assess their possible biodegradation. Because of the negative effects of high salt concentration (3%), heavy metals and toxic organic matter on microorganisms’ activities, some techniques consisting of dilution, coagulation and flocculation, and ozonation pretreatments, were gradually tested to evaluate chemical oxygen demand (COD), ammonia-nitrogen (ammonia-N) and total nitrogen (TN) removal rates. In this process of FCC wastewater, starting with university-domesticated sludge, the ammonia-N and TN removal rates were worst. However, when using domesticated SBR’s sludge and operating with five-fold daily diluted influent (thus reducing salt concentration), the ammonia-N removal reached about 57% while the TN removal rate was less than 37% meaning an amelioration of the nitrification process. However, by reducing the dilution factors, these results were inflected after some days of operation, with ammonia-N removal decreasing and TN barely removed meaning a poor nitrification. Even by reducing heavy metals concentration with coagulation/flocculation process, the results never changed. Thereafter, by using ozonation pre-treatment to degrade the detected organic matter of di-tert-butylphenol and certain isoparaffins, COD, ammonia-N and TN removal rates reached 92%, 62% and 61%, respectively. These results showed that the activities of the microorganisms were increased, thus indicating a net denitrification and nitrification reactions improvement.展开更多
BacKground Laparoscopic cholecystectomy has been widely used in clinical practice during the recent decades; however, the effects of pneumoperitoneum and the surgery on the coagulation system are largely unknown. This...BacKground Laparoscopic cholecystectomy has been widely used in clinical practice during the recent decades; however, the effects of pneumoperitoneum and the surgery on the coagulation system are largely unknown. This clinical study aimed to observe any possible effects of pneumoperitoneum and the surgery on the coagulation system of patients. Methods This was a prospective observational study. The inclusion criteria included （1） patients with chronic cholecystitis and/or cholecystic polyps and （2） patients in the relief stage of acute cholecystitis. The exclusion criteria included （1） patients in the episodic stage of acute cholecystitis and those complicated with cholangiolithiasis; （2） patients with concomitant hematologic diseases, damages to the liver function, malignant tumors or immune system diseases, or patients complicated with thrombotic or hemorrhagic disorders; and （3） patients who had taken anticoagulant medication within a week before surgery. Fifty patients who were hospitalized into our department for elective laparoscopic cholecystectomy between November 2011 and February 2013 were eligible and enrolled into this study. Of the 50 patients, 22 were male and 28 female. The age of the patients ranged from 29 to 78 （mean 56.7±11.5） years. The surgery for each of the 50 patients was performed with the same equipment and conditions. The surgeries for all the patients were performed under general anesthesia with the patients in a 30-degree head-up tilted posture, and the pressure of pneumoperitoneum was maintained at 13 mmHg. Venous blood specimens were taken from each patient before and at the end of pneumoperitoneum （i.e., 0 hour after surgery） and at 8 hours after surgery for determination of prothrombin time （PT）, activated partial thromboplastin time （APTT）, fibrinogen （Fib）, thrombin time （TT）, and D-dimer （DD）. The results of the determinations of these parameters were compared. Results （1） All the patients recovered well without any complications. （2） The pre-pneumoperitoneum values of the parameters of coagulation had normalized. （3） The PT values slightly increased （P 〉0.05） at the end of pneumoperitoneum （i.e., 0 hour after surgery） and decreased by 0.5 seconds at 8 hours after surgery as compared to the pre-pneumopedtoneum values （P 〈0.05）. （4） APTT at 0 and 8 hours decreased by 1.4 seconds （P 〉0.05） and 3.7＇ seconds （P 〈0.05） respectively as compared to pre-pneumoperitoneum values, while the difference between the APTT values at 0 and 8 hours after surgery was not statistically significant （P 〉0.05）. （5） FIB determined at 0 hour post-operation increased by 0.1 g/L as compared to pre-pneumoperitoneum values （P 〉0.05）; however, the FIB values at 8 hours after operation increased by 1.2 g/L as compared to the pre-pneumoperitoneum values （P 〈0.05）, and increased by 1.1 g/L as compared to 0 hour post-operation （P 〈0.05）. （6） The TT values obtained at 0 and 8 hours post-operation were not significantly different as compared to the pre-pneumoperitoneum values （P 〉0.05）. （7） The DD values gradually increased after operation; as compared to pre-pneumoperitoneum values, DD at 0 and 8 hours after operation increased by 210.8 ng/ml and 525.9 ng/ml respectively （P 〈0.05） and DD at 8 hours after operation increased by 315.1 ng/ml as compared to 0 hour post-operation （P 〈0.05）. Conclusions The pneumoperitoneum for laparoscopic cholecycstectomy may lead to postoperative hypercoagulation in the patients, and thereby may increase the risks for development of postoperative thrombosis;Patients may have risks展开更多
Summary: To evaluate the effect of lower intensity anticoagulation therapy in patients with mechanical prosthetic valves, laboratory based hematological assays including prothrombin time (PT), activity of factor X, a...Summary: To evaluate the effect of lower intensity anticoagulation therapy in patients with mechanical prosthetic valves, laboratory based hematological assays including prothrombin time (PT), activity of factor X, antithrombin Ⅲ (AT Ⅲ), D dimer, fibrinogen (Fg) and platel et al pha granular membrane protein (GMP 140) were performed in 65 patients who had been on warfarin treatment for over one month. The patients were assigned to 3 groups on the basis of their International Normalized Ratios (INR), ranging from 2.00 to 2.50; 2.51 to 3.00; 3.01 to 4.50, respectively. The results showed that the D dimer, Fg, GMP 140 levels were higher after mechanical valve replacement than those before operation, indicating the activation of coagulation and fibrinolysis system and the damage of platelets. Lower intensity anticoagulation therapy (INR 2 00 to 2.50) could effectively inhibit the activity of factor X and increase the level of AT Ⅲ. There were no appreciable differences among D dimer, Fg, GMP 140 and AT Ⅲ in the 3 anticoagulation intensity groups. These results suggest that in patients with new generation mechanical prosthetic valves, target anticoagulation level (INR 2 00 to 2.50) may result in good protection from thrombo embolism.展开更多
A N 2 flotation tank combined with coagulation was developed as a pretreatment equipment of biological process to remove oil and other pollutants in coal gasification wastewater( CGW). With optimal PAC dosage of 20 mg...A N 2 flotation tank combined with coagulation was developed as a pretreatment equipment of biological process to remove oil and other pollutants in coal gasification wastewater( CGW). With optimal PAC dosage of 20 mg / L,the sole coagulation process achieves removal efficiencies of 29. 34% and 26. 83% for oil and COD,respectively. For the sole N 2 floatation process,the optimal N 2 flux and HRT are 20 m3/ h and 20 min. Meanwhile,the oil and COD removal efficiencies are 35. 41% and 14. 26%,respectively. For the combined system of coagulation and N 2 floatation,the optimal parameter values are the same as the ones of separate processes. Correspondingly,the removal efficiencies are 46. 28% and 31. 89% for oil and COD, respectively. Besides,BOD 5 / COD of the effluent is improved. In contrast with conventional dissolved air floatation,the inert gas- N 2 prevents the formation of cyclopentenone, pyridine derivatives, and other heterocyclic aromatic hydrocarbons,thus improving the biodegradability of influent for the subsequent biological processes.展开更多
Objective:To evaluate coagulation abnormalities and their relationship with bleeding manifestations among patients with dengue.Methods:This observational study was conducted on 292 adult dengue patients who were admit...Objective:To evaluate coagulation abnormalities and their relationship with bleeding manifestations among patients with dengue.Methods:This observational study was conducted on 292 adult dengue patients who were admitted to a tertiary care hospital of Western India from July 2021 to June 2022.Coagulation tests including prothrombin time(PT),international normalized ratio(INR),activated partial thromboplastin time(aPTT),fibrinogen,and D-dimer were performed.Patients were monitored for bleeding manifestations.Results:Coagulation abnormalities were reported in 42.8%of the patients.Overall,prolonged aPTT was the most common coagulation abnormality(40.8%),followed by low fibrinogen(38.7%),raised D-dimer(31.2%),raised INR(26.0%)and prolonged PT(19.2%).Bleeding manifestations were present in 19.9%patients.PT,INR,aPTT and D-dimer levels were significantly higher(P<0.01)and fibrinogen level was significantly lower(P<0.001)in patients with bleeding compared to patients without bleeding.Patients with bleeding had a significantly higher rate of all coagulation abnormalities than patients without bleeding(P<0.01).Conclusions:Patients with bleeding showed a significantly higher frequency of coagulation abnormalities compared to patients without bleeding.Patients with dengue should be assessed for coagulation abnormalities.展开更多
Objective:To investigate the effect of a large number of blood transfusion on coagulation function and fibrinolytic system in patients with acute trauma.Methods:A total of 86 cases of traumatic blood transfusion emerg...Objective:To investigate the effect of a large number of blood transfusion on coagulation function and fibrinolytic system in patients with acute trauma.Methods:A total of 86 cases of traumatic blood transfusion emergency and hospitalized patients during January 2014 to January 2016 in our hospital, divided into two groups according to the early blood transfusion, acute trauma patients need a lot of blood transfusion for the observation group (47 cases), trauma patients need a small amount of blood transfusion as the control group (39 cases). Statistical analysis and comparison of two groups patients of four blood coagulation [prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT), fibrinogen (FIB)], platelet count (PLT), protein C (PC) and fiber soluble system index [D dimer (D-D), fibrin degradation products (FDP) levels before and after blood transfusion of 1 d, 5 d'. Results:Before blood transfusion, there was no significant difference between the two groups. There was no significant difference in the level of the observed indexes in the control group before and after transfusion. 1 d after blood transfusion, compared with blood transfusion before and the control group at the same time , the observation group PT[(18.4±4.3) s], APTT[(42.9±7) s], TT[(21.4±4.8) s] were significantly prolonged, D-D[(282.2±115) g/L] and FDP[(6.3±2.1) mg/L] were significantly increased, and FIB[(2.9±1.3) g/L], PLT[(72.5±34.4) 109] and PC[(2.4±1.2) mg/L] levels were significantly decreased. 5 d after blood transfusion, compared with blood transfusion before and the control group at the same time ,the observation indexes showed no significant difference;5 D after blood transfusion compared with 1 D, the observation group PT[(14.8±1.7) s], APTT[(34.7±5.4) s], TT[(14.7±2.5) s] was significantly shortened, D-D[(151.8±62.4) g/L] and FDP[(3.7±1.2) mg/L] were significantly decreased, FIB[(3.7±0.8) g/L], PLT[(179±70.8) 109] and PC[(3.9±1.5) mg/L] levels were significantly higher.Conclusion:Large amount of blood transfusion has great influence on the coagulation function and fibrinolysis system in acute trauma patients. It is necessary to monitor coagulation status in time and avoid complications such as coagulation dysfunction, so as to improve the success rate of implementation of massive transfusion regimen.展开更多
Objective: To study the effect of dexmedetomidine combined with ulinastatin on RAAS system, coagulation indexes and oxygen free radicals after acute aortic dissection surgery. Methods: A total of 48 patients with aort...Objective: To study the effect of dexmedetomidine combined with ulinastatin on RAAS system, coagulation indexes and oxygen free radicals after acute aortic dissection surgery. Methods: A total of 48 patients with aortic dissection who accepted endovascular graft exclusion treatment in the hospital between May 2014 and February 2017 were selected and randomly divided into two groups, group A received dexmedetomidine, ulinastatin combined with general anesthesia, and group B received general anesthesia. The RAAS hormones, coagulation indexes and oxygen free radical indexes were measured 1 d before surgery, during operation and 24 h after surgery. Results: During operation and after operation, serum REN, AT-II, ALD, FIB, DD, MDA and MPO contents as well as APTT and TT levels of both groups of patients were significantly higher than those before operation while TAOC and TSOD contents were significantly lower than those before operation, and serum REN, AT-II, ALD, FIB, DD, MDA and MPO contents as well as APTT and TT levels of group A were significantly lower than those of group B while TAOC and TSOD contents were significantly higher than those of group B. Conclusion: Dexmedetomidine combined with ulinastatin for acute aortic dissection can inhibit RAAS system and oxygen free radical generation and improve coagulation function.展开更多
Objective:To observe the effect of urokinase thrombolysis on the cardiac function, coagulation, and fibrinolytic system in patients with acute myocardial infarction (AMI). Methods: A total of 39 patients with AMI who ...Objective:To observe the effect of urokinase thrombolysis on the cardiac function, coagulation, and fibrinolytic system in patients with acute myocardial infarction (AMI). Methods: A total of 39 patients with AMI who were admitted in our hospital from March, 2016 to November, 2016 were included in the study and served as the observation group. The peripheral venous blood before and after thrombolysis was collected. The plasma NT-proBNP level, related coagulation factors, and fibrinolysis indicators were detected. The cardiac function before treatment was evaluated. A total of 30 healthy individuals who came for physical examinations were served as the control group for contrastive analysis.Results:The plasma NT-proBNP, Fg, and D-D levels before thrombolysis in the observation group were significantly higher than those in the control group, while PT, APTT, and TT in the observation group were significantly shortened. The plasma NT-proBNP and D-D levels 2-48 h after thrombolysis in the observation group were significantly elevated first and reduced later and reached the peak 4 h after treatment, while PT, APTT, and TT were significantly extended first and shortened later. The plasma Fg level was significantly reduced first and elevated later and reached the minimum 4 h after treatment. During the treatment process, in the observation group, 2 had mucocutaneous hemorrhage, 3 had nasal hemorrhage, and 1 had gingival bleeding, but no gastrointestinal bleeding or cerebral hemorrhage occurred.Conclusions:The thrombolytic therapy can effectively reduce the coagulation activity in patients with AMI, strengthen the fibrinolysis activity, and improve the cardiac function.展开更多
BACKGROUND Bradyarrhythmias are typically treated with permanent pacemakers(PM). The elimination of bradyarrhythmia by PM implantation improves the patient’s quality of life and prognosis, but it can also result in a...BACKGROUND Bradyarrhythmias are typically treated with permanent pacemakers(PM). The elimination of bradyarrhythmia by PM implantation improves the patient’s quality of life and prognosis, but it can also result in a number of sequalae. It is still unclear how PM implantation affects the hemostasis system’s parameters and how such parameters relate to different consequences after PM placement.AIM To assess the blood coagulation factor activity in PM patients throughout the perioperative period.METHODS Patients treated in the Department of Surgical Therapy of Cardiac Arrhythmias and Pacing at the Ryazan State "Regional Clinical Cardiology Dispensary" from April 2020 to December 2021 were included in the study. Before surgery, 7 and 30 d after PM placement, peripheral venous blood samples were withdrawn to measure the level of blood coagulation factor Ⅰ(FⅠ) and the activity of blood coagulation factors Ⅱ(FⅡ), Ⅴ(FⅤ), Ⅶ(FⅦ), Ⅷ(FⅧ), ⅸ(Fⅸ), ⅹ(Fⅹ), Ⅺ(FⅪ), Ⅻ(FⅫ). We used an automatic coagulometer Sysmex CA 660(Sysmex Europe, Germany) and reagents from Siemens(Siemens Healthcare Diagnostics Products GmbH, Germany).RESULTS The study included 146 patients. The activity of factors FⅤ [147.7(102.1-247.55)% vs 103.85(60-161.6)% vs 81.8(67.15-130.65)%, P = 0.002], FⅧ [80.4(60.15-106.25)% vs 70.3(48.5-89.1)% vs 63.7(41.6-88.25)%, P = 0.039], Fⅸ [86.2(70.75-102.95)% vs 75.4(59.2-88.3)% vs 73.9(56.45-93.05)%, P = 0.014], Fⅹ [188.9(99.3-308.18)% vs 158.9(83.3-230)% vs 127.2(95.25-209.35)%, P = 0.022], FⅪ [82.6(63.9-103.6)% vs 69.75(53.8-97.6)% vs 67.3(54.25-98.05)%, P = 0.002], FⅫ [87.6(67.15-102.3)% vs 78.9(63.4-97.05)% vs 81.2(62.15-97.4)%, P < 0.001] decreased at 7 and 30 d after surgery;FⅡ activity [157.9(109.7-245.25)% vs 130(86.8-192.5)% vs 144.8(103.31-185.6)%, P = 0.021] decreased at 7 d and increased at 30 d postoperatively. There were no statistically significant changes in the FVII activity within 30 d after PM placement [182.2(85.1-344.8)% vs 157.2(99.1-259)% vs 108.9(74.9-219.8)%, P = 0.128]. Subgroup analysis revealed similar changes only in patients on anticoagulant therapy. FⅫ activity decreased in patients on antiplatelet therapy [82(65.8-101.9)% vs 79.9(63.3-97.1)% vs 89.7(75.7-102.5)%, P = 0.01] 7 d after surgery, returning to baseline values at 30 d postoperatively.CONCLUSION PM placement and anticoagulant therapy were associated with decreased activity of clotting factors FⅤ, FⅧ, Fⅸ, Fⅹ, FⅪ, FⅫ in the postoperative period. FⅧ activity did not decrease within 30 d after PM placement, which may indicate endothelial injury caused by lead placement.展开更多
BACKGROUND Bones are one of the most common target organs for cancer metastasis.Early evaluation of bone metastasis(BM)status is clinically significant.Cancer patients often experience a hypercoagulable state.AIM To e...BACKGROUND Bones are one of the most common target organs for cancer metastasis.Early evaluation of bone metastasis(BM)status is clinically significant.Cancer patients often experience a hypercoagulable state.AIM To evaluate the correlation between coagulation indicators and the burden of BM in gastric cancer(GC).METHODS We conducted a single-center retrospective study and enrolled 454 patients.Clinical information including routine blood examination and coagulation markers were collected before any treatment.Patients were grouped according to the status of BM.Receiver operating characteristic curves were used to assess diagnostic performance and determine the optimal cutoff values of the above indicators.Cutoff values,sensitivity and specificity were based on the maximum Youden index.Univariate and multivariate logistic regression analyses were used to evaluate the relationships between biomarkers and BM.RESULTS Of the 454 enrolled patients,191 patients were diagnosed with BM.The receiver operating characteristic curve analysis suggested that prothrombin time(PT)Wang X et al.Coagulation indicators predict bone metastasis WJGO https://www.wjgnet.com 1254 July 15,2023 Volume 15 Issue 7[cutoff:13.25;sensitivity:0.651;specificity:0.709;area under receiver operating characteristic curve(AUC)=0.738],activated partial thromboplastin time(aPTT)(cutoff:35.15;sensitivity:0.640;specificity:0.640;AUC=0.678)and fibrin degradation products(FDP)(cutoff:2.75;sensitivity:0.668;specificity:0.801;AUC=0.768)act as novel predictors for BM.Based on multivariate logistic regression analysis,the results showed the independent correlation between PT[odds ratio(OR):3.16;95%confidence interval(CI):1.612-6.194;P=0.001],aPTT(OR:2.234;95%CI:1.157-4.313;P=0.017)and FDP(OR:3.17;95%CI:1.637-6.139;P=0.001)and BM in patients with GC.Moreover,age,carcinoembryonic antigen,erythrocyte and globulin were found to be significantly associated with BM.CONCLUSION Coagulation markers,namely PT,aPTT and FDP,might be potential predictors for screening BM in patients with GC.展开更多
[Objectives]This study was conducted to obtain a Chinese hamster ovary cell line that stably expresses recombinant human coagulation factor X(rhFX),and to induce efficient expression of the target gene with different ...[Objectives]This study was conducted to obtain a Chinese hamster ovary cell line that stably expresses recombinant human coagulation factor X(rhFX),and to induce efficient expression of the target gene with different concentrations of methotrexate(MTX).[Methods]PCR was performed to obtain the rhFX gene,and a recombinant expression plasmid pOptiVEC-rhFX was constructed and subjected to double restriction endonuclease digestion and sequencing identification.CHO-DG44(DHFR-)cells were transfected by the liposome method,and the target protein was purified by affinity chromatography and detected by SDS-PAGE electrophoresis and Western blot.A cell line with efficient and stable expression of the target gene was obtained by increasing the concentration of MTX to select positive clones.[Results]PCR yielded a 1509 bp rhFX sequence,and the results of double digestion and sequencing showed that the constructed pOptiVEC-rhFX plasmid was correct.After transfection of cells,MTX significantly increased protein expression.When MTX reached 1.0μmol/L,the expression efficiency of the target protein was(9±0.27)μg/ml.The purity of the target protein purified by affinity chromatography was 93%,which could be used for subsequent experiments.The expression efficiency of rhFX in eukaryotic mammalian cells was improved by increasing MTX concentration,and an affinity chromatography purification process for the target protein was preliminarily established.[Conclusions]The results of this study provide data support for the expression and purification of rhFX,and will lay a solid foundation for the development of drugs related to rhFX.展开更多
In this article, a new type of coagulant material has been investigated and the performance of the coagulation process using this type of coagulant was evaluated. This new type is a combination of zinc oxide nanoparti...In this article, a new type of coagulant material has been investigated and the performance of the coagulation process using this type of coagulant was evaluated. This new type is a combination of zinc oxide nanoparticles and polyferric sulfate (ZnOPFS). The structure of zinc oxide nanoparticles was determined by spectroscopic, X-ray and electron microscopy methods, and based on this, it was determined that ZnOPFS is a complex and mixed compound that is mainly composed of zinc oxide nanoparticles and ferric sulfate. The effects of Zn/Fe (Zn/Fe) molar ratio and aging (time) on acidity and zeta potential were also evaluated using a specific method. The obtained results showed that in the simultaneous deposition process, zinc ions can prevent the formation of polyferric acid coagulation and subsequently improve the stability of ZnOPFS.展开更多
Waterborne viruses account for 30% to 40% of infectious diarrhea, and some viruses could persevere for some months in nature and move up to 100 m in groundwater. Using filtration setups, coagulation could lessen virus...Waterborne viruses account for 30% to 40% of infectious diarrhea, and some viruses could persevere for some months in nature and move up to 100 m in groundwater. Using filtration setups, coagulation could lessen virus charges as an efficient pre-treatment for reducing viruses. This work discusses the present-day studies on virus mitigation using coagulation in its three versions i.e., chemical coagulation (CC), enhanced coagulation, and electrocoagulation (EC), and debates the new results of virus demobilization. The complexity of viruses as bioparticles and the process of virus demobilization should be adopted, even if the contribution of permeability in virus sorption and aggregation needs to be clarified. The information about virion permeability has been evaluated by interpreting empirical electrophoretic mobility (EM). No practical measures of virion permeability exist, a clear link between permeability and virion composition and morphology has not been advanced, and the direct influence of inner virion structures on surface charge or sorption has yet to be conclusively demonstrated. CC setups utilizing zero-valent or ferrous iron could be killed by iron oxidation, possibly using EC and electrooxidation (EO) methods. The oxidants evolution in the iron oxidation method has depicted promising findings in demobilizing bacteriophage MS2, even if follow-up investigations employing an elution method are needed to secure that bacteriophage elimination is related to demobilization rather than sorption. As a perspective, we could be apt to anticipate virus conduct and determine new bacteriophage surrogates following subtle aspects such as protein structures or genome size and conformation. The present discussion’s advantages would extend far beyond an application in CC—from filtration setups to demobilization by nanoparticles to modeling virus fate and persistence in nature.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19)has demonstrated several clinical manifestations which include not only respiratory system issues but also liver,kidney,and other organ injuries.One of these abnormalities ...BACKGROUND Coronavirus disease 2019(COVID-19)has demonstrated several clinical manifestations which include not only respiratory system issues but also liver,kidney,and other organ injuries.One of these abnormalities is coagulopathies,including thrombosis and disseminated intravascular coagulation.Because of this,the administration of low molecular weight heparin is required for patients that need to be hospitalized.In addition,Remdesivir is an antiviral that was used against Middle East Acute Respiratory Syndrome,Ebola,Acute Respiratory Syndrome,and other diseases,showing satisfactory results on recovery.Besides,there is evidence suggesting that this medication can provide a better prognosis for patients with COVID-19.AIM To investigate in silico the interaction between Remdesivir and clotting factors,pursuing a possibility of using it as medicine.METHODS In this in silico study,the 3D structures of angiotensin-converting enzyme 2(ACE2),Factor I(fibrinogen),Factor II(prothrombin),Factor III(thromboplastin),Factor V(proaccelerin),Factor VII(proconvertin),Factor VIII(antihemophilic factor A),Factor IX(antihemophilic factor B),Factor X(Stuart-Prower factor),and Factor XI(precursor of thromboplastin(these structures are technically called receptors)were selected from the Protein Data Bank.The structures of the antivirals Remdesivir and Osetalmivir(these structures are called ligands)were selected from the PubChem database,while the structure of Atazanavir was selected from the ZINC database.The software AutoDock Tools(ADT)was used to prepare the receptors for molecular docking.Ions,peptides,water molecules,and other ones were removed from each ligand,and then,hydrogen atoms were added to the structures.The grid box was delimited and calculated using the same software ADT.A physiological environment with pH 7.4 is needed to make the ligands interact with the receptors,and still the software Marvin sketch®(ChemAxon®)was used to forecast the protonation state.To perform molecular docking,ADT and Vina software was connected.Using PyMol®software and Discovery studio®software from BIOVIA,it was possible to analyze the amino acid residues from receptors that were involved in the interactions with the ligands.Ligand tortions,atoms that participated in the interactions,and the type,strength,and duration of the interactions were also analyzed using those software.RESULTS Molecular docking analysis showed that Remdesivir and ACE2 had an affinity energy of-8.8 kcal/moL,forming a complex with eight hydrogen bonds involving seven atoms of Remdesivir and five amino acid residues of ACE2.Remdesivir and prothrombin had an interaction with six hydrogen bonds involving atoms of the drug and five amino acid residues of the clotting factor.Similar to that,Remdesivir and thromboplastin presented interactions via seven hydrogen bonds involving five atoms of the drug and four residues of the clotting factor.While Remdesivir and Factor V established a complex with seven hydrogen bonds between six antiviral atoms and six amino acid residues from the factor,and Factor VII connected with the drug by four hydrogen bonds,which involved three atoms of the drug and three residues of amino acids of the factor.The complex between Remdesivir and Factor IX formed an interaction via 11 hydrophilic bonds with seven atoms of the drug and seven residues of the clotting factor,plus one electrostatic bond and three hydrophobic interactions.Factor X and Remdesivir had an affinity energy of-9.6 kcal/moL,and the complex presented 10 hydrogen bonds and 14 different hydrophobic interactions which involved nine atoms of the drug and 16 amino acid residues of the clotting factor.The interaction between Remdesivir and Factor XI formed five hydrogen bonds involving five amino acid residues of the clotting factor and five of the antiviral atoms.CONCLUSION Because of the in silico significant affinity,Remdesivir possibly could act in the severe acute respiratory syndrome coronavirus 2 infection blockade by interacting with ACE2 and concomitantly act in the modulation of the coagulation cascade preventing the hypercoagulable state.展开更多
Background:Peanut shells are a commonly discarded byproduct of peanut processing.However,recent studies have shown that they contain bioactive compounds that have potential health benefits.Specifically,water extract f...Background:Peanut shells are a commonly discarded byproduct of peanut processing.However,recent studies have shown that they contain bioactive compounds that have potential health benefits.Specifically,water extract from peanut shells has been identified as a promising source of these compounds.Therefore,investigating the effects of water extract from peanut shells on coagulation and analgesia in mice could have significant implications for human health.Methods:(1)Analgesic experiments:The analgesic effect of the aqueous extract of peanut shells was observed by the hot plate method in mice.The aspirin group was used as a positive control group for analgesic experiments.(2)Coagulation experiment:the coagulation effect of the aqueous extract of peanut shells was observed by the capillary method and slide method.Yunnan Baiyao group was the positive control group of the coagulation test.Results:(1)The analgesic effect of peanut shell water extract on mice was prolonged with the increase in dose.The low,medium,and high dose groups of peanut shell could improve the pain domain of mice induced by the hot plate method in a certain period(P<0.05);with the increase of peanut shell water extract dose,liver weight coefficient increased(P<0.05).(2)Peanut shell water extract coagulated mice,and the high-dose group of peanut shells was the most significant.Within the scope of this study,the higher the concentration,the better the coagulation effect(P<0.05).Compared with distilled water group,the liver weight coefficients of the Yunnan Baiyao group,low,middle,and high dose groups of peanut shells were significantly increased(P<0.05).Conclusion:(1)The aqueous extract of peanut shells has a specific analgesic effect on mice.(2)The aqueous extract of peanut shells promotes coagulation,and the pro-coagulant effect is more significant with increasing dose and the liver weight coefficient increases.展开更多
Sepsis is a life-threatening syndrome resulting from a dysregulated host response to infection.It is the primary cause of death in the intensive care unit,posing a substantial challenge to human health and medical res...Sepsis is a life-threatening syndrome resulting from a dysregulated host response to infection.It is the primary cause of death in the intensive care unit,posing a substantial challenge to human health and medical resource allocation.The pathogenesis and pathophysiology of sepsis are complex.During its onset,pro-inflammatory and anti-inflammatory mechanisms engage in intricate interactions,possibly leading to hyperinflammation,immuno-suppression,and long-term immune disease.Of all critical outcomes,hyperinflammation is the main cause of early death among patients with sepsis.Therefore,early suppression of hyperinflammation may improve the progno-sis of these patients.Nafamostat mesilate is a serine protease inhibitor,which can inhibit the activation of the complement system,coagulation system,and contact system.In this review,we discuss the pathophysiological changes occurring in these systems during sepsis,and describe the possible targets of the serine protease inhibitor nafamostat mesilate in the treatment of this condition.展开更多
[Objective] The aim was to treat acidic wastewater containing thallium by enhanced coagulation oxidation process. [Method] Enhanced coagulation oxidation process was made use of to remove thallium in the acidic wastew...[Objective] The aim was to treat acidic wastewater containing thallium by enhanced coagulation oxidation process. [Method] Enhanced coagulation oxidation process was made use of to remove thallium in the acidic wastewater in the experiment under the condition of 0.05 kg/L of potassium permanganate, 30% hydrogen peroxide and 0.05 kg/L calcium hypochlorite as oxidant, together with 0.092 kg/L CaO as coagulation. [Result] The results showed that thallium removal efficiencies achieved 99.98%, 99.1% and 99.95% when dosages of KMnO4, H2O2and Ca（ClO）2were added at 20, 2.2 and 37 ml, respectively, under the condition of 30 ml 0.092kg/L CaO being dosed and 99.93%, 99.69% and 99.98% were achieved when different dosages of CaO were added at 25, 35 and 25 ml, under the condition of 20ml KMnO4, 2.2 ml H2O2and 37 ml Ca（ClO）2respectively. [Conclusion] The experiment demonstrates that good removal effects of removal thallium from the acidic wastewater would be achieved by enhanced coagulation oxidation process.展开更多
基金supported by grants from National Key R&D Program of China(No.2023YFC2507800)ECCM Program of Clinical Research Centre of Shandong University(No.2021SDUCRCB008)+2 种基金Young Taishan Scholar Foundation of Shandong Province(No.tsqn201812133)the Fundamental Research Funds of Shandong University(No.2020QNQT001)National Natural Science Foundation of China(No.81900124).
文摘Objective Coagulation abnormalities are common and prognostically significant in intensive care units(ICUs)and are associated with increased mortality.This study aimed to explore the association between the levels of coagulation markers and the risk of mortality among ICU patients with coagulation abnormalities.Methods This retrospective study investigated patients with coagulation abnormalities in the ICU between January 2021 and December 2022.The initial point for detecting hemostatic biomarkers due to clinical assessment of coagulation abnormalities was designated day 0.Patients were followed up for 28 days,and multivariate logistic regression analysis was utilized to identify risk factors for mortality.Results Of the 451 patients analyzed,115 died,and 336 were alive at the end of the 28-day period.Multivariate analysis revealed that elevated thrombin-antithrombin complex(TAT),tissue plasminogen activator inhibitor complex(tPAIC),prolonged prothrombin time,and thrombocytopenia were independent risk factors for mortality.For nonovert disseminated intravascular coagulation(DIC)patients,older age and thrombocytopenia were associated with increased risks of mortality,whereas elevated levels of plasminα2-plasmin inhibitor complex(PIC)were found to be independent predictors of survival.In patients with overt DIC,elevated levels of tPAIC were independently associated with increased risks of mortality.Nevertheless,thrombocytopenia was independently associated with increased risks of mortality in patients with pre-DIC.Conclusion Coagulation markers such as the TAT,tPAIC,PIC,and platelet count were significantly associated with mortality,underscoring the importance of maintaining a balance between coagulation and fibrinolysis.These findings highlight the potential for targeted therapeutic interventions based on specific coagulation markers to improve patient outcomes.
基金supported by the National Key Research and Development Program of China(2021YFC2501800)Shanghai Committee of Science and Technology(20Y11900100,21MC1930400,and 20DZ2261200)Clinical Research Plan of Shanghai Hospital Development Center(SHDC2020CR4059)。
文摘BACKGROUND:Disseminated intravascular coagulation(DIC)is associated with increased mortality in sepsis patients.In this study,we aimed to assess the clinical ability of sepsis-induced coagulopathy(SIC)and sepsis-associated coagulopathy(SAC)criteria in identifying overt-DIC and preDIC status in sepsis patients.METHODS:Data from 419 sepsis patients were retrospectively collected from July 2018 to December 2022.The performances of the SIC and SAC were assessed to identify overt-DIC on days 1,3,7,or 14.The SIC status or SIC score on day 1,the SAC status or SAC score on day 1,and the sum of the SIC or SAC scores on days 1 and 3 were compared in terms of their ability to identify pre-DIC.The SIC or SAC status on day 1 was evaluated as a pre-DIC indicator for anticoagulant initiation.RESULTS:On day 1,the incidences of coagulopathy according to overt-DIC,SIC and SAC criteria were 11.7%,22.0%and 31.5%,respectively.The specificity of SIC for identifying overt-DIC was significantly higher than that of the SAC criteria from day 1 to day 14(P<0.05).On day 1,the SIC score with a cut-off value>3 had a significantly higher sensitivity(72.00%)and area under the curve(AUC)(0.69)in identifying pre-DIC than did the SIC or SAC status(sensitivity:SIC status 44.00%,SAC status 52.00%;AUC:SIC status 0.62,SAC status 0.61).The sum of the SIC scores on days 1 and 3 had a higher AUC value for identifying the pre-DIC state than that of SAC(0.79 vs.0.69,P<0.001).Favorable effects of anticoagulant therapy were observed in SIC(adjusted hazard ratio[HR]=0.216,95%confidence interval[95%CI]:0.060–0.783,P=0.018)and SAC(adjusted HR=0.146,95%CI:0.041–0.513,P=0.003).CONCLUSION:The SIC and SAC seem to be valuable for predicting overt-DIC.The sum of SIC scores on days 1 and 3 has the potential to help identify pre-DIC.
文摘BACKGROUND The incidence of Barrett’s esophagus(BE)in China is lower compared to the Western populations.Hence,studies conducted in the Chinese population has been limited.The current treatment options available for BE treatment includes argon plasma coagulation(APC),radiofrequency ablation and cryoablation,all with varying degrees of success.AIM To determine the efficacy and safety of HybridAPC in the treatment of BE.METHODS The study cohort consisted of patients with BE who underwent HybridAPC ablation treatment.These procedures were performed by seven endoscopists from different tertiary hospitals.The duration of the procedure,curative rate,complications and recurrent rate by 1-year follow-up were recorded.RESULTS Eighty individuals were enrolled for treatment from July 2017 to June 2020,comprising of 39 males and 41 females with a median age of 54 years(range,30 to 83 years).The technical success rate of HybridAPC was 100%and the overall curative rate was 98.15%.No severe complications occurred during the operation.BE cases were classified as short-segment BE and long-segment BE.Patients with short-segment BE were all considered cured without complications.Thirty-six patients completed the one-year follow-up without recurrence.Twenty-four percent had mild dysplasia which were all resolved with one post-procedural treatment.The mean duration of the procedure was 10.94±6.52 min.CONCLUSION Treatment of BE with HybridAPC was found to be a simple and quick procedure that is safe and effective during the short-term follow-up,especially in cases of short-segment BE.This technique could be considered as a feasible alternative ablation therapy for BE.
文摘Fluid catalytic cracking (FCC) salty wastewaters, containing quaternary ammonium compounds (QACs), are very difficult to treat by biochemical process. Anoxic/oxic (A/O) biochemical system, based on nitrification and denitrification reactions, was used to assess their possible biodegradation. Because of the negative effects of high salt concentration (3%), heavy metals and toxic organic matter on microorganisms’ activities, some techniques consisting of dilution, coagulation and flocculation, and ozonation pretreatments, were gradually tested to evaluate chemical oxygen demand (COD), ammonia-nitrogen (ammonia-N) and total nitrogen (TN) removal rates. In this process of FCC wastewater, starting with university-domesticated sludge, the ammonia-N and TN removal rates were worst. However, when using domesticated SBR’s sludge and operating with five-fold daily diluted influent (thus reducing salt concentration), the ammonia-N removal reached about 57% while the TN removal rate was less than 37% meaning an amelioration of the nitrification process. However, by reducing the dilution factors, these results were inflected after some days of operation, with ammonia-N removal decreasing and TN barely removed meaning a poor nitrification. Even by reducing heavy metals concentration with coagulation/flocculation process, the results never changed. Thereafter, by using ozonation pre-treatment to degrade the detected organic matter of di-tert-butylphenol and certain isoparaffins, COD, ammonia-N and TN removal rates reached 92%, 62% and 61%, respectively. These results showed that the activities of the microorganisms were increased, thus indicating a net denitrification and nitrification reactions improvement.
文摘BacKground Laparoscopic cholecystectomy has been widely used in clinical practice during the recent decades; however, the effects of pneumoperitoneum and the surgery on the coagulation system are largely unknown. This clinical study aimed to observe any possible effects of pneumoperitoneum and the surgery on the coagulation system of patients. Methods This was a prospective observational study. The inclusion criteria included （1） patients with chronic cholecystitis and/or cholecystic polyps and （2） patients in the relief stage of acute cholecystitis. The exclusion criteria included （1） patients in the episodic stage of acute cholecystitis and those complicated with cholangiolithiasis; （2） patients with concomitant hematologic diseases, damages to the liver function, malignant tumors or immune system diseases, or patients complicated with thrombotic or hemorrhagic disorders; and （3） patients who had taken anticoagulant medication within a week before surgery. Fifty patients who were hospitalized into our department for elective laparoscopic cholecystectomy between November 2011 and February 2013 were eligible and enrolled into this study. Of the 50 patients, 22 were male and 28 female. The age of the patients ranged from 29 to 78 （mean 56.7±11.5） years. The surgery for each of the 50 patients was performed with the same equipment and conditions. The surgeries for all the patients were performed under general anesthesia with the patients in a 30-degree head-up tilted posture, and the pressure of pneumoperitoneum was maintained at 13 mmHg. Venous blood specimens were taken from each patient before and at the end of pneumoperitoneum （i.e., 0 hour after surgery） and at 8 hours after surgery for determination of prothrombin time （PT）, activated partial thromboplastin time （APTT）, fibrinogen （Fib）, thrombin time （TT）, and D-dimer （DD）. The results of the determinations of these parameters were compared. Results （1） All the patients recovered well without any complications. （2） The pre-pneumoperitoneum values of the parameters of coagulation had normalized. （3） The PT values slightly increased （P 〉0.05） at the end of pneumoperitoneum （i.e., 0 hour after surgery） and decreased by 0.5 seconds at 8 hours after surgery as compared to the pre-pneumopedtoneum values （P 〈0.05）. （4） APTT at 0 and 8 hours decreased by 1.4 seconds （P 〉0.05） and 3.7＇ seconds （P 〈0.05） respectively as compared to pre-pneumoperitoneum values, while the difference between the APTT values at 0 and 8 hours after surgery was not statistically significant （P 〉0.05）. （5） FIB determined at 0 hour post-operation increased by 0.1 g/L as compared to pre-pneumoperitoneum values （P 〉0.05）; however, the FIB values at 8 hours after operation increased by 1.2 g/L as compared to the pre-pneumoperitoneum values （P 〈0.05）, and increased by 1.1 g/L as compared to 0 hour post-operation （P 〈0.05）. （6） The TT values obtained at 0 and 8 hours post-operation were not significantly different as compared to the pre-pneumoperitoneum values （P 〉0.05）. （7） The DD values gradually increased after operation; as compared to pre-pneumoperitoneum values, DD at 0 and 8 hours after operation increased by 210.8 ng/ml and 525.9 ng/ml respectively （P 〈0.05） and DD at 8 hours after operation increased by 315.1 ng/ml as compared to 0 hour post-operation （P 〈0.05）. Conclusions The pneumoperitoneum for laparoscopic cholecycstectomy may lead to postoperative hypercoagulation in the patients, and thereby may increase the risks for development of postoperative thrombosis;Patients may have risks
文摘Summary: To evaluate the effect of lower intensity anticoagulation therapy in patients with mechanical prosthetic valves, laboratory based hematological assays including prothrombin time (PT), activity of factor X, antithrombin Ⅲ (AT Ⅲ), D dimer, fibrinogen (Fg) and platel et al pha granular membrane protein (GMP 140) were performed in 65 patients who had been on warfarin treatment for over one month. The patients were assigned to 3 groups on the basis of their International Normalized Ratios (INR), ranging from 2.00 to 2.50; 2.51 to 3.00; 3.01 to 4.50, respectively. The results showed that the D dimer, Fg, GMP 140 levels were higher after mechanical valve replacement than those before operation, indicating the activation of coagulation and fibrinolysis system and the damage of platelets. Lower intensity anticoagulation therapy (INR 2 00 to 2.50) could effectively inhibit the activity of factor X and increase the level of AT Ⅲ. There were no appreciable differences among D dimer, Fg, GMP 140 and AT Ⅲ in the 3 anticoagulation intensity groups. These results suggest that in patients with new generation mechanical prosthetic valves, target anticoagulation level (INR 2 00 to 2.50) may result in good protection from thrombo embolism.
基金Sponsored by the Sino-Dutch Research Program(Grant No.SDRP-WRZ)the State Key Laboratory of Urban Water Resource and Environment,Harbin Institute of Technology(Grant No.2013DX10)
文摘A N 2 flotation tank combined with coagulation was developed as a pretreatment equipment of biological process to remove oil and other pollutants in coal gasification wastewater( CGW). With optimal PAC dosage of 20 mg / L,the sole coagulation process achieves removal efficiencies of 29. 34% and 26. 83% for oil and COD,respectively. For the sole N 2 floatation process,the optimal N 2 flux and HRT are 20 m3/ h and 20 min. Meanwhile,the oil and COD removal efficiencies are 35. 41% and 14. 26%,respectively. For the combined system of coagulation and N 2 floatation,the optimal parameter values are the same as the ones of separate processes. Correspondingly,the removal efficiencies are 46. 28% and 31. 89% for oil and COD, respectively. Besides,BOD 5 / COD of the effluent is improved. In contrast with conventional dissolved air floatation,the inert gas- N 2 prevents the formation of cyclopentenone, pyridine derivatives, and other heterocyclic aromatic hydrocarbons,thus improving the biodegradability of influent for the subsequent biological processes.
文摘Objective:To evaluate coagulation abnormalities and their relationship with bleeding manifestations among patients with dengue.Methods:This observational study was conducted on 292 adult dengue patients who were admitted to a tertiary care hospital of Western India from July 2021 to June 2022.Coagulation tests including prothrombin time(PT),international normalized ratio(INR),activated partial thromboplastin time(aPTT),fibrinogen,and D-dimer were performed.Patients were monitored for bleeding manifestations.Results:Coagulation abnormalities were reported in 42.8%of the patients.Overall,prolonged aPTT was the most common coagulation abnormality(40.8%),followed by low fibrinogen(38.7%),raised D-dimer(31.2%),raised INR(26.0%)and prolonged PT(19.2%).Bleeding manifestations were present in 19.9%patients.PT,INR,aPTT and D-dimer levels were significantly higher(P<0.01)and fibrinogen level was significantly lower(P<0.001)in patients with bleeding compared to patients without bleeding.Patients with bleeding had a significantly higher rate of all coagulation abnormalities than patients without bleeding(P<0.01).Conclusions:Patients with bleeding showed a significantly higher frequency of coagulation abnormalities compared to patients without bleeding.Patients with dengue should be assessed for coagulation abnormalities.
文摘Objective:To investigate the effect of a large number of blood transfusion on coagulation function and fibrinolytic system in patients with acute trauma.Methods:A total of 86 cases of traumatic blood transfusion emergency and hospitalized patients during January 2014 to January 2016 in our hospital, divided into two groups according to the early blood transfusion, acute trauma patients need a lot of blood transfusion for the observation group (47 cases), trauma patients need a small amount of blood transfusion as the control group (39 cases). Statistical analysis and comparison of two groups patients of four blood coagulation [prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT), fibrinogen (FIB)], platelet count (PLT), protein C (PC) and fiber soluble system index [D dimer (D-D), fibrin degradation products (FDP) levels before and after blood transfusion of 1 d, 5 d'. Results:Before blood transfusion, there was no significant difference between the two groups. There was no significant difference in the level of the observed indexes in the control group before and after transfusion. 1 d after blood transfusion, compared with blood transfusion before and the control group at the same time , the observation group PT[(18.4±4.3) s], APTT[(42.9±7) s], TT[(21.4±4.8) s] were significantly prolonged, D-D[(282.2±115) g/L] and FDP[(6.3±2.1) mg/L] were significantly increased, and FIB[(2.9±1.3) g/L], PLT[(72.5±34.4) 109] and PC[(2.4±1.2) mg/L] levels were significantly decreased. 5 d after blood transfusion, compared with blood transfusion before and the control group at the same time ,the observation indexes showed no significant difference;5 D after blood transfusion compared with 1 D, the observation group PT[(14.8±1.7) s], APTT[(34.7±5.4) s], TT[(14.7±2.5) s] was significantly shortened, D-D[(151.8±62.4) g/L] and FDP[(3.7±1.2) mg/L] were significantly decreased, FIB[(3.7±0.8) g/L], PLT[(179±70.8) 109] and PC[(3.9±1.5) mg/L] levels were significantly higher.Conclusion:Large amount of blood transfusion has great influence on the coagulation function and fibrinolysis system in acute trauma patients. It is necessary to monitor coagulation status in time and avoid complications such as coagulation dysfunction, so as to improve the success rate of implementation of massive transfusion regimen.
文摘Objective: To study the effect of dexmedetomidine combined with ulinastatin on RAAS system, coagulation indexes and oxygen free radicals after acute aortic dissection surgery. Methods: A total of 48 patients with aortic dissection who accepted endovascular graft exclusion treatment in the hospital between May 2014 and February 2017 were selected and randomly divided into two groups, group A received dexmedetomidine, ulinastatin combined with general anesthesia, and group B received general anesthesia. The RAAS hormones, coagulation indexes and oxygen free radical indexes were measured 1 d before surgery, during operation and 24 h after surgery. Results: During operation and after operation, serum REN, AT-II, ALD, FIB, DD, MDA and MPO contents as well as APTT and TT levels of both groups of patients were significantly higher than those before operation while TAOC and TSOD contents were significantly lower than those before operation, and serum REN, AT-II, ALD, FIB, DD, MDA and MPO contents as well as APTT and TT levels of group A were significantly lower than those of group B while TAOC and TSOD contents were significantly higher than those of group B. Conclusion: Dexmedetomidine combined with ulinastatin for acute aortic dissection can inhibit RAAS system and oxygen free radical generation and improve coagulation function.
文摘Objective:To observe the effect of urokinase thrombolysis on the cardiac function, coagulation, and fibrinolytic system in patients with acute myocardial infarction (AMI). Methods: A total of 39 patients with AMI who were admitted in our hospital from March, 2016 to November, 2016 were included in the study and served as the observation group. The peripheral venous blood before and after thrombolysis was collected. The plasma NT-proBNP level, related coagulation factors, and fibrinolysis indicators were detected. The cardiac function before treatment was evaluated. A total of 30 healthy individuals who came for physical examinations were served as the control group for contrastive analysis.Results:The plasma NT-proBNP, Fg, and D-D levels before thrombolysis in the observation group were significantly higher than those in the control group, while PT, APTT, and TT in the observation group were significantly shortened. The plasma NT-proBNP and D-D levels 2-48 h after thrombolysis in the observation group were significantly elevated first and reduced later and reached the peak 4 h after treatment, while PT, APTT, and TT were significantly extended first and shortened later. The plasma Fg level was significantly reduced first and elevated later and reached the minimum 4 h after treatment. During the treatment process, in the observation group, 2 had mucocutaneous hemorrhage, 3 had nasal hemorrhage, and 1 had gingival bleeding, but no gastrointestinal bleeding or cerebral hemorrhage occurred.Conclusions:The thrombolytic therapy can effectively reduce the coagulation activity in patients with AMI, strengthen the fibrinolysis activity, and improve the cardiac function.
文摘BACKGROUND Bradyarrhythmias are typically treated with permanent pacemakers(PM). The elimination of bradyarrhythmia by PM implantation improves the patient’s quality of life and prognosis, but it can also result in a number of sequalae. It is still unclear how PM implantation affects the hemostasis system’s parameters and how such parameters relate to different consequences after PM placement.AIM To assess the blood coagulation factor activity in PM patients throughout the perioperative period.METHODS Patients treated in the Department of Surgical Therapy of Cardiac Arrhythmias and Pacing at the Ryazan State "Regional Clinical Cardiology Dispensary" from April 2020 to December 2021 were included in the study. Before surgery, 7 and 30 d after PM placement, peripheral venous blood samples were withdrawn to measure the level of blood coagulation factor Ⅰ(FⅠ) and the activity of blood coagulation factors Ⅱ(FⅡ), Ⅴ(FⅤ), Ⅶ(FⅦ), Ⅷ(FⅧ), ⅸ(Fⅸ), ⅹ(Fⅹ), Ⅺ(FⅪ), Ⅻ(FⅫ). We used an automatic coagulometer Sysmex CA 660(Sysmex Europe, Germany) and reagents from Siemens(Siemens Healthcare Diagnostics Products GmbH, Germany).RESULTS The study included 146 patients. The activity of factors FⅤ [147.7(102.1-247.55)% vs 103.85(60-161.6)% vs 81.8(67.15-130.65)%, P = 0.002], FⅧ [80.4(60.15-106.25)% vs 70.3(48.5-89.1)% vs 63.7(41.6-88.25)%, P = 0.039], Fⅸ [86.2(70.75-102.95)% vs 75.4(59.2-88.3)% vs 73.9(56.45-93.05)%, P = 0.014], Fⅹ [188.9(99.3-308.18)% vs 158.9(83.3-230)% vs 127.2(95.25-209.35)%, P = 0.022], FⅪ [82.6(63.9-103.6)% vs 69.75(53.8-97.6)% vs 67.3(54.25-98.05)%, P = 0.002], FⅫ [87.6(67.15-102.3)% vs 78.9(63.4-97.05)% vs 81.2(62.15-97.4)%, P < 0.001] decreased at 7 and 30 d after surgery;FⅡ activity [157.9(109.7-245.25)% vs 130(86.8-192.5)% vs 144.8(103.31-185.6)%, P = 0.021] decreased at 7 d and increased at 30 d postoperatively. There were no statistically significant changes in the FVII activity within 30 d after PM placement [182.2(85.1-344.8)% vs 157.2(99.1-259)% vs 108.9(74.9-219.8)%, P = 0.128]. Subgroup analysis revealed similar changes only in patients on anticoagulant therapy. FⅫ activity decreased in patients on antiplatelet therapy [82(65.8-101.9)% vs 79.9(63.3-97.1)% vs 89.7(75.7-102.5)%, P = 0.01] 7 d after surgery, returning to baseline values at 30 d postoperatively.CONCLUSION PM placement and anticoagulant therapy were associated with decreased activity of clotting factors FⅤ, FⅧ, Fⅸ, Fⅹ, FⅪ, FⅫ in the postoperative period. FⅧ activity did not decrease within 30 d after PM placement, which may indicate endothelial injury caused by lead placement.
文摘BACKGROUND Bones are one of the most common target organs for cancer metastasis.Early evaluation of bone metastasis(BM)status is clinically significant.Cancer patients often experience a hypercoagulable state.AIM To evaluate the correlation between coagulation indicators and the burden of BM in gastric cancer(GC).METHODS We conducted a single-center retrospective study and enrolled 454 patients.Clinical information including routine blood examination and coagulation markers were collected before any treatment.Patients were grouped according to the status of BM.Receiver operating characteristic curves were used to assess diagnostic performance and determine the optimal cutoff values of the above indicators.Cutoff values,sensitivity and specificity were based on the maximum Youden index.Univariate and multivariate logistic regression analyses were used to evaluate the relationships between biomarkers and BM.RESULTS Of the 454 enrolled patients,191 patients were diagnosed with BM.The receiver operating characteristic curve analysis suggested that prothrombin time(PT)Wang X et al.Coagulation indicators predict bone metastasis WJGO https://www.wjgnet.com 1254 July 15,2023 Volume 15 Issue 7[cutoff:13.25;sensitivity:0.651;specificity:0.709;area under receiver operating characteristic curve(AUC)=0.738],activated partial thromboplastin time(aPTT)(cutoff:35.15;sensitivity:0.640;specificity:0.640;AUC=0.678)and fibrin degradation products(FDP)(cutoff:2.75;sensitivity:0.668;specificity:0.801;AUC=0.768)act as novel predictors for BM.Based on multivariate logistic regression analysis,the results showed the independent correlation between PT[odds ratio(OR):3.16;95%confidence interval(CI):1.612-6.194;P=0.001],aPTT(OR:2.234;95%CI:1.157-4.313;P=0.017)and FDP(OR:3.17;95%CI:1.637-6.139;P=0.001)and BM in patients with GC.Moreover,age,carcinoembryonic antigen,erythrocyte and globulin were found to be significantly associated with BM.CONCLUSION Coagulation markers,namely PT,aPTT and FDP,might be potential predictors for screening BM in patients with GC.
基金Supported by Anhui Provincial Natural Science Foundation of China(2008085MC65)Natural Science Foundation of Anhui Higher Education Institutions of China(KJ2021A0922)+1 种基金China Postdoctoral Science Foundation(2020T130117ZX,2020M671914)Research Activities of Postdoctoral Researchers Foundation of Anhui Province,China(2020B470)。
文摘[Objectives]This study was conducted to obtain a Chinese hamster ovary cell line that stably expresses recombinant human coagulation factor X(rhFX),and to induce efficient expression of the target gene with different concentrations of methotrexate(MTX).[Methods]PCR was performed to obtain the rhFX gene,and a recombinant expression plasmid pOptiVEC-rhFX was constructed and subjected to double restriction endonuclease digestion and sequencing identification.CHO-DG44(DHFR-)cells were transfected by the liposome method,and the target protein was purified by affinity chromatography and detected by SDS-PAGE electrophoresis and Western blot.A cell line with efficient and stable expression of the target gene was obtained by increasing the concentration of MTX to select positive clones.[Results]PCR yielded a 1509 bp rhFX sequence,and the results of double digestion and sequencing showed that the constructed pOptiVEC-rhFX plasmid was correct.After transfection of cells,MTX significantly increased protein expression.When MTX reached 1.0μmol/L,the expression efficiency of the target protein was(9±0.27)μg/ml.The purity of the target protein purified by affinity chromatography was 93%,which could be used for subsequent experiments.The expression efficiency of rhFX in eukaryotic mammalian cells was improved by increasing MTX concentration,and an affinity chromatography purification process for the target protein was preliminarily established.[Conclusions]The results of this study provide data support for the expression and purification of rhFX,and will lay a solid foundation for the development of drugs related to rhFX.
文摘In this article, a new type of coagulant material has been investigated and the performance of the coagulation process using this type of coagulant was evaluated. This new type is a combination of zinc oxide nanoparticles and polyferric sulfate (ZnOPFS). The structure of zinc oxide nanoparticles was determined by spectroscopic, X-ray and electron microscopy methods, and based on this, it was determined that ZnOPFS is a complex and mixed compound that is mainly composed of zinc oxide nanoparticles and ferric sulfate. The effects of Zn/Fe (Zn/Fe) molar ratio and aging (time) on acidity and zeta potential were also evaluated using a specific method. The obtained results showed that in the simultaneous deposition process, zinc ions can prevent the formation of polyferric acid coagulation and subsequently improve the stability of ZnOPFS.
文摘Waterborne viruses account for 30% to 40% of infectious diarrhea, and some viruses could persevere for some months in nature and move up to 100 m in groundwater. Using filtration setups, coagulation could lessen virus charges as an efficient pre-treatment for reducing viruses. This work discusses the present-day studies on virus mitigation using coagulation in its three versions i.e., chemical coagulation (CC), enhanced coagulation, and electrocoagulation (EC), and debates the new results of virus demobilization. The complexity of viruses as bioparticles and the process of virus demobilization should be adopted, even if the contribution of permeability in virus sorption and aggregation needs to be clarified. The information about virion permeability has been evaluated by interpreting empirical electrophoretic mobility (EM). No practical measures of virion permeability exist, a clear link between permeability and virion composition and morphology has not been advanced, and the direct influence of inner virion structures on surface charge or sorption has yet to be conclusively demonstrated. CC setups utilizing zero-valent or ferrous iron could be killed by iron oxidation, possibly using EC and electrooxidation (EO) methods. The oxidants evolution in the iron oxidation method has depicted promising findings in demobilizing bacteriophage MS2, even if follow-up investigations employing an elution method are needed to secure that bacteriophage elimination is related to demobilization rather than sorption. As a perspective, we could be apt to anticipate virus conduct and determine new bacteriophage surrogates following subtle aspects such as protein structures or genome size and conformation. The present discussion’s advantages would extend far beyond an application in CC—from filtration setups to demobilization by nanoparticles to modeling virus fate and persistence in nature.
文摘BACKGROUND Coronavirus disease 2019(COVID-19)has demonstrated several clinical manifestations which include not only respiratory system issues but also liver,kidney,and other organ injuries.One of these abnormalities is coagulopathies,including thrombosis and disseminated intravascular coagulation.Because of this,the administration of low molecular weight heparin is required for patients that need to be hospitalized.In addition,Remdesivir is an antiviral that was used against Middle East Acute Respiratory Syndrome,Ebola,Acute Respiratory Syndrome,and other diseases,showing satisfactory results on recovery.Besides,there is evidence suggesting that this medication can provide a better prognosis for patients with COVID-19.AIM To investigate in silico the interaction between Remdesivir and clotting factors,pursuing a possibility of using it as medicine.METHODS In this in silico study,the 3D structures of angiotensin-converting enzyme 2(ACE2),Factor I(fibrinogen),Factor II(prothrombin),Factor III(thromboplastin),Factor V(proaccelerin),Factor VII(proconvertin),Factor VIII(antihemophilic factor A),Factor IX(antihemophilic factor B),Factor X(Stuart-Prower factor),and Factor XI(precursor of thromboplastin(these structures are technically called receptors)were selected from the Protein Data Bank.The structures of the antivirals Remdesivir and Osetalmivir(these structures are called ligands)were selected from the PubChem database,while the structure of Atazanavir was selected from the ZINC database.The software AutoDock Tools(ADT)was used to prepare the receptors for molecular docking.Ions,peptides,water molecules,and other ones were removed from each ligand,and then,hydrogen atoms were added to the structures.The grid box was delimited and calculated using the same software ADT.A physiological environment with pH 7.4 is needed to make the ligands interact with the receptors,and still the software Marvin sketch®(ChemAxon®)was used to forecast the protonation state.To perform molecular docking,ADT and Vina software was connected.Using PyMol®software and Discovery studio®software from BIOVIA,it was possible to analyze the amino acid residues from receptors that were involved in the interactions with the ligands.Ligand tortions,atoms that participated in the interactions,and the type,strength,and duration of the interactions were also analyzed using those software.RESULTS Molecular docking analysis showed that Remdesivir and ACE2 had an affinity energy of-8.8 kcal/moL,forming a complex with eight hydrogen bonds involving seven atoms of Remdesivir and five amino acid residues of ACE2.Remdesivir and prothrombin had an interaction with six hydrogen bonds involving atoms of the drug and five amino acid residues of the clotting factor.Similar to that,Remdesivir and thromboplastin presented interactions via seven hydrogen bonds involving five atoms of the drug and four residues of the clotting factor.While Remdesivir and Factor V established a complex with seven hydrogen bonds between six antiviral atoms and six amino acid residues from the factor,and Factor VII connected with the drug by four hydrogen bonds,which involved three atoms of the drug and three residues of amino acids of the factor.The complex between Remdesivir and Factor IX formed an interaction via 11 hydrophilic bonds with seven atoms of the drug and seven residues of the clotting factor,plus one electrostatic bond and three hydrophobic interactions.Factor X and Remdesivir had an affinity energy of-9.6 kcal/moL,and the complex presented 10 hydrogen bonds and 14 different hydrophobic interactions which involved nine atoms of the drug and 16 amino acid residues of the clotting factor.The interaction between Remdesivir and Factor XI formed five hydrogen bonds involving five amino acid residues of the clotting factor and five of the antiviral atoms.CONCLUSION Because of the in silico significant affinity,Remdesivir possibly could act in the severe acute respiratory syndrome coronavirus 2 infection blockade by interacting with ACE2 and concomitantly act in the modulation of the coagulation cascade preventing the hypercoagulable state.
基金supported by several organizations,including the National Natural Science Foundation of China(No.81360684)the State Administration of Traditional Chinese Medicine(2012 No.32)+1 种基金the Guangxi Key Discipline of Pharmaceutical Chemistry(2017 No.22)the National-level training program for college students’innovation and entrepreneurship(No.201810599013).
文摘Background:Peanut shells are a commonly discarded byproduct of peanut processing.However,recent studies have shown that they contain bioactive compounds that have potential health benefits.Specifically,water extract from peanut shells has been identified as a promising source of these compounds.Therefore,investigating the effects of water extract from peanut shells on coagulation and analgesia in mice could have significant implications for human health.Methods:(1)Analgesic experiments:The analgesic effect of the aqueous extract of peanut shells was observed by the hot plate method in mice.The aspirin group was used as a positive control group for analgesic experiments.(2)Coagulation experiment:the coagulation effect of the aqueous extract of peanut shells was observed by the capillary method and slide method.Yunnan Baiyao group was the positive control group of the coagulation test.Results:(1)The analgesic effect of peanut shell water extract on mice was prolonged with the increase in dose.The low,medium,and high dose groups of peanut shell could improve the pain domain of mice induced by the hot plate method in a certain period(P<0.05);with the increase of peanut shell water extract dose,liver weight coefficient increased(P<0.05).(2)Peanut shell water extract coagulated mice,and the high-dose group of peanut shells was the most significant.Within the scope of this study,the higher the concentration,the better the coagulation effect(P<0.05).Compared with distilled water group,the liver weight coefficients of the Yunnan Baiyao group,low,middle,and high dose groups of peanut shells were significantly increased(P<0.05).Conclusion:(1)The aqueous extract of peanut shells has a specific analgesic effect on mice.(2)The aqueous extract of peanut shells promotes coagulation,and the pro-coagulant effect is more significant with increasing dose and the liver weight coefficient increases.
基金supported by the National Natural Science Foundation of China(grant numbers 82102287)Key dis-cipline of Shanghai’s Three-year Action Plan to Strengthen the construction of public health system(2023-2025)(grant num-bers GWVI-11.1-14).
文摘Sepsis is a life-threatening syndrome resulting from a dysregulated host response to infection.It is the primary cause of death in the intensive care unit,posing a substantial challenge to human health and medical resource allocation.The pathogenesis and pathophysiology of sepsis are complex.During its onset,pro-inflammatory and anti-inflammatory mechanisms engage in intricate interactions,possibly leading to hyperinflammation,immuno-suppression,and long-term immune disease.Of all critical outcomes,hyperinflammation is the main cause of early death among patients with sepsis.Therefore,early suppression of hyperinflammation may improve the progno-sis of these patients.Nafamostat mesilate is a serine protease inhibitor,which can inhibit the activation of the complement system,coagulation system,and contact system.In this review,we discuss the pathophysiological changes occurring in these systems during sepsis,and describe the possible targets of the serine protease inhibitor nafamostat mesilate in the treatment of this condition.
基金National Natural Science Foundation(51208122)Department of Science and Technology of Guangdong Province(2010B030900008)New Special Science and Technology Project of Pearl River and College Students’Innovative Entrepreneurial Training Plan Project in Guangdong Province~~
文摘[Objective] The aim was to treat acidic wastewater containing thallium by enhanced coagulation oxidation process. [Method] Enhanced coagulation oxidation process was made use of to remove thallium in the acidic wastewater in the experiment under the condition of 0.05 kg/L of potassium permanganate, 30% hydrogen peroxide and 0.05 kg/L calcium hypochlorite as oxidant, together with 0.092 kg/L CaO as coagulation. [Result] The results showed that thallium removal efficiencies achieved 99.98%, 99.1% and 99.95% when dosages of KMnO4, H2O2and Ca（ClO）2were added at 20, 2.2 and 37 ml, respectively, under the condition of 30 ml 0.092kg/L CaO being dosed and 99.93%, 99.69% and 99.98% were achieved when different dosages of CaO were added at 25, 35 and 25 ml, under the condition of 20ml KMnO4, 2.2 ml H2O2and 37 ml Ca（ClO）2respectively. [Conclusion] The experiment demonstrates that good removal effects of removal thallium from the acidic wastewater would be achieved by enhanced coagulation oxidation process.
