BACKGROUND Gastric cancer has a high incidence and fatality rate,and surgery is the preferred course of treatment.Nonetheless,patient survival rates are still low,and the incidence of major postoperative complications...BACKGROUND Gastric cancer has a high incidence and fatality rate,and surgery is the preferred course of treatment.Nonetheless,patient survival rates are still low,and the incidence of major postoperative complications cannot be disregarded.The systemic inflammatory response,nutritional level,and coagulation status are key factors affecting the postoperative recovery and prognosis of gastric cancer patients.The systemic inflammatory response index(SIRI)and the albumin fibrinogen ratio(AFR)are two valuable comprehensive indicators of the severity and prognosis of systemic inflammation in various medical conditions.AIM To assess the clinical importance and prognostic significance of the SIRI scores and the AFR on early postoperative outcomes in patients undergoing radical gastric cancer surgery.METHODS We conducted a retrospective analysis of the clinicopathological characteristics and relevant laboratory indices of 568 gastric cancer patients from January 2018 to December 2019.We calculated and compared two indicators of inflammation and then examined the diagnostic ability of combined SIRI and AFR values for serious early postoperative complications.We scored the patients and categorized them into three groups based on their SIRI and AFR levels.COX analysis was used to compare the three groups of patients the prognostic value of various preoperative SIRI-AFR scores for 5-year overall survival(OS)and disease-free survival(DFS).RESULTS SIRI-AFR scores were an independent risk factor for prognosis[OS:P=0.004;hazards ratio(HR)=3.134;DFS:P<0.001;HR=3.543]and had the highest diagnostic power(area under the curve:0.779;95%confidence interval:0.737-0.820)for early serious complications in patients with gastric cancer.The tumor-node-metastasis stage(P=0.001),perioperative transfusion(P=0.044),positive carcinoembryonic antigen(P=0.014)findings,and major postoperative complications(P=0.011)were factors associated with prognosis.CONCLUSION Preoperative SIRI and AFR values were significantly associated with early postoperative survival and the occurrence of severe complications in gastric cancer patients.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19)pandemic unmasked the huge deficit in healthcare resources worldwide.It highlighted the need for efficient risk stratification in management of cardiovascular emergencies.A...BACKGROUND Coronavirus disease 2019(COVID-19)pandemic unmasked the huge deficit in healthcare resources worldwide.It highlighted the need for efficient risk stratification in management of cardiovascular emergencies.AIM To study the applicability of the old,available and affordable nonconventional biomarkers:albumin and fibrinogen in their ability to predict angiographic severity and clinical outcomes in patients with acute coronary syndrome(ACS).METHODS In this prospective,observational study,166 consecutive patients with ACS were enrolled.Fibrinogen,albumin and their ratio were determined from serum.Patients with underlying chronic liver disease,active malignancy,autoimmune disease,active COVID-19 infection and undergoing thrombolysis were excluded.RESULTS Mean age of the population was 60.5±1.5 years,74.1%being males.ST elevation myocardial infarction(STEMI)was most common presentation of ACS seen in 57%patients.Fibrinogen albumin ratio(FAR)≥19.2,had a sensitivity of 76.9%and specificity of 78.9%[area under the receiver operating characteristic curves(AUROC)=0.8,P=0.001]to predict≤thrombolysis in myocardial infarction(TIMI)1 flow in culprit artery in STEMI patients.Even in non-STEMI patients,FAR≥18.85 predicted the same with 80%sensitivity and 63%specificity(AUROC=0.715,P=0.006).CONCLUSION Novel biomarkers,with their high cost,lack of availability and long turn over time are impractical for real-world use.Identifying≤TIMI 1 flow in the culprit artery has significant impact of management and outcome.Our study has shown that readily available biomarkers like fibrinogen and albumin can help identify these high-risk patients with good accuracy.This allows risk-stratification and individualization of treatment in ACS.展开更多
Biodegradable hydrogels are promising biomaterials for use in controlled-release systems for skin tissue regeneration. Controlled delivery systems constitute an important aspect of tissue engineering because they can ...Biodegradable hydrogels are promising biomaterials for use in controlled-release systems for skin tissue regeneration. Controlled delivery systems constitute an important aspect of tissue engineering because they can modulate various physiological responses, including early immune response, tissue remodeling, and cell proliferation and maturation in the wound-healing process. Hydrogels composed of various biomaterials have been developed to overcome the limitations of conventional drug- or protein-delivery systems, such as limited targeting ability, low stability, and the induction of drug resistance. Hydrogels based on keratin, a natural polymer extracted from human hair, can provide adequate cell support and control homeostasis. Consequently, they can be applied for skin tissue engineering. In this study, we prepared degradable, tunable, and biocompatible hydrogels for controllable protein delivery. We synthesized keratin-fibrinogen (KER-FBG) by the chemical coupling reaction and prepared hydrogels through polymerization with thrombin. The structures and morphologies of the KER-FBG hydrogels were confirmed. Furthermore, the mechanical properties, swelling ratio, degradation, release behavior, and biocompatibility were investigated. The KER-FBG hydrogels presented promising biological performance, indicating that the material is suitable as a controlled protein delivery carrier.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
Objective:To investigate the effect of heparin on fibrinogen detection by Clauss method.Methods:A normal plasma pool(NPP)of 20 healthy people was prepared with 3.2%sodium citrate anticoagulant.For experimental group 1...Objective:To investigate the effect of heparin on fibrinogen detection by Clauss method.Methods:A normal plasma pool(NPP)of 20 healthy people was prepared with 3.2%sodium citrate anticoagulant.For experimental group 1,samples containing different concentrations of heparin were prepared.For experimental group 2,samples of experimental group 1 were diluted twice.For experimental group 3,samples of experimental group 1 were diluted 4 times.For the control group,samples of normal saline with the same volume as heparin in experimental group 1 were prepared.The fibrinogen contents of experimental group 1,experimental group 2,experimental group 3,and control group were detected by Clauss method and prothrombin time(PT)-derived method,and the fibrinogen detection results of different groups were analyzed.Results:The trend of fibrinogen detected by Clauss method and PT-derived method in experimental group 1 was different;there was significant difference between the results of experimental group 1 and the control group(P<0.05);there was no significant difference between the results of experimental group 2 and the control group(P>0.05);there was no significant difference between the results of experimental group 3 and the control group(P>0.05);there was no significant difference between the results of experimental group 2 and experimental group 3(P>0.05);the relative deviation between experimental group 1 and the control group was higher in high-concentration heparin sample.Conclusion:Heparin affects fibrinogen detection by Clauss method,and the effect can be reduced by sample dilution.展开更多
AIM To investigate the prognostic role of fibrinogen-toalbumin ratio(FAR) on patients with gallbladder cancer(Gbc) in this study.METHODS One hundred and fifty-four Gbc patients were retro-spectively analyzed, who rece...AIM To investigate the prognostic role of fibrinogen-toalbumin ratio(FAR) on patients with gallbladder cancer(Gbc) in this study.METHODS One hundred and fifty-four Gbc patients were retro-spectively analyzed, who received potentially curative cholecystectomy in our institute from March 2005 to December 2017. Receiver operating characteristic curve(ROc curve) was used to determine the optimal cut-offs for these biomarkers. In addition, Kaplan-Meier survival analysis as well as multivariate analysis were applied for prognostic analyses.RESULTS ROc curve revealed that the optimal cut-off value for FAR was 0.08. FAR was significantly correlated with age(P = 0.045), jaundice(P < 0.001), differentiation(P = 0.002), resection margin status(P < 0.001), T stage(P < 0.001), TNM stage(P < 0.001), and c A199(P < 0.001) as well as albumin levels(P < 0.001). Multivariate analysis indicated that the resection margin status [hazard ratio(HR): 2.343, 95% confidence interval(c I): 1.532-3.581, P < 0.001], TNM stage(P = 0.035), albumin level(HR = 0.595, 95%c I: 0.385-0.921, P = 0.020) and FAR(HR: 2.813, 95%c I: 1.765-4.484, P < 0.001) were independent prognostic factors in Gbc patients.CONCLUSION An elevated preoperative FAR was significantly correlated with unfavorable overall survival in Gbc patients, while an elevated preoperative albumin level was a protective prognostic factor for patients with Gbc. The preoperative FAR could be used to predict the prognosis of Gbc patients, which was easily accessible, costeffective and noninvasive.展开更多
Objective Hemocoagulase injection based on the venom of Agkistrodon halys Pallas is widely used in the treatment of hemorrhagic disorders.This study aimed to characterize the clinical laboratory findings of hemocoagul...Objective Hemocoagulase injection based on the venom of Agkistrodon halys Pallas is widely used in the treatment of hemorrhagic disorders.This study aimed to characterize the clinical laboratory findings of hemocoagulase-induced hypofibrinogenemia as the associated adverse reaction of hemocoagulase injection.Methods Wie retrospectively enrolled 27 in-patients who were treated with hemocoagulase injection for hemoptysis and developed hypofibrinogenemia during the period of January 1,2015 to March 31,2018.Clinical data were collected and investigated,including clinical manifestations,hemostatic and fibrinolytic parameters,dosage of hemocoagulase,the medication time,and the cryoprecipitate blood product infusion.Differences in fibrinogen,D-dimer,and fibrin/fibrinogen degradation products(FDP)before,during,and after the application of hemocoagulase injection were analyzed statistically.Results Plasma fibrinogen level during medication of hemocoagulase injection decreased significantly compared to that before the treatment(F=1.80,P<0.001),with the average decrease of 2.28 g/L(0.63-3.9 g/L).After withdrawal,fibrinogen level increased significantly compared to that during the medication(F=l.20,P<0.001),but was still lower than that before the medication(F=0.59,P=0.03).The D-dimer level and the FDP level after withdrawal decreased significantly compared to the levels during the medication(F=0.83,P=0.002;Wilcoxon-test,Z=-4.54,P<0.001).Spearman's correlation analyses did not find either fibrinogen change during-before the administration or FDP change after-during the administration was associated with the dosage of hemo coagulase(r=-0.17,P=0.40;r=-0.28,P=0.15;respectively)and the time of recovery from hypofibrinogenemia(r=-0.45,P=0.05;r=0.13,P=0.61;respectively).Conclusion Monitoring both clotting and fibrinolysis parameters is essential in the management of hemoptysis patients treated with hemocoagulase injection.Clinicians should be aware of hypofibrinogenemia and consider discontinuation of the administration of hemocoagulase whenever necessary.展开更多
BACKGROUND Venom-induced consumption coagulopathy(VICC)is characterized by coagulation dysfunction accompanied by decreased coagulation factor activity and fibrinogen(FBG)concentrations.We report a patient with VICC c...BACKGROUND Venom-induced consumption coagulopathy(VICC)is characterized by coagulation dysfunction accompanied by decreased coagulation factor activity and fibrinogen(FBG)concentrations.We report a patient with VICC caused by snake bite who manifested persistent FBG deficiency without abnormal coagulation factor activity.This information may be helpful in diagnosing and treating VICC.CASE SUMMARY A 49-year-old man who had been bitten by a snake 13 h previously was admitted to the Emergency Department of our hospital with visible swelling of a finger and a bleeding puncture site.The provisional diagnosis was VICC,this being made based on persistent bleeding from the puncture site and subcutaneous hemorrhage.Laboratory evidence of coagulation abnormalities,including fibrinolysis,and findings on thromboelastography confirmed VICC.He had persistent afibrinogenemia requiring intravenous infusions of cryoprecipitate and fresh frozen plasma,together with continuous large doses of human FBG.After this treatment,the patient’s right upper limb swelling improved significantly and his subcutaneous hemorrhage resolved.All of his abnormal laboratory findings returned to normal by day 25.During 6 months’of follow-up,the patient had no further hemorrhagic events.CONCLUSION Hemorrhagic snake venom can result in coagulation dysfunction characterized by persistent FBG deficiency without abnormal coagulation factor activity.展开更多
BACKGROUND The purpose of this study was to report the rare case of a pregnant woman with congenital dysfibrinogenemia(CD)misdiagnosed as acute fatty liver.She was treated according to the principles of acute fatty li...BACKGROUND The purpose of this study was to report the rare case of a pregnant woman with congenital dysfibrinogenemia(CD)misdiagnosed as acute fatty liver.She was treated according to the principles of acute fatty liver but achieved good clinical results.CASE SUMMARY A 30-year-old woman presented with 39(6/7)wk of menopause and 6 h of irregular abdominal pain and attended our hospital.Emergency surgery was performed due to fetal distress.Postoperative management followed the treatment principle of acute fatty liver.DNA sequencing was carried out on the pregnant woman and her pedigree.Coagulation values of the patient on admission were prothrombin time 33.7 s,activated partial thromboplastin time 60.4 s,thrombin time 45.2 s,and fibrinogen 0.60 g/L.DNA sequencing results showed that the woman carried a pathogenic heterozygous variation of the fibrinogen alpha chain gene(FGA),which is closely related to hereditary fibrinogen abnormality,and the mutation site was located in p.R350H.After a follow-up period of 12 mo,the mother and her newborn had a good prognosis without bleeding or thrombosis.CONCLUSION Pregnant women with CD may have atypical symptoms,which can easily lead to misdiagnosis.In addition,treatment can be attempted according to the principles of acute fatty liver management.This rare pregnant patient with CD was caused by a novel FGA(p.R350H)gene mutation.展开更多
A serine proteinase with a fibrinogenase activity was isolated from the venom of viper Echis multisquamatis. Isolation was performed by the combination of Q-sepharose and Heparine-agarose chromatography. The enzyme ha...A serine proteinase with a fibrinogenase activity was isolated from the venom of viper Echis multisquamatis. Isolation was performed by the combination of Q-sepharose and Heparine-agarose chromatography. The enzyme has apparent molecular weight 35 ± 1 kDа. It posesses strong fibrinogen β-chain, moderate αchain proteolytic activity, arginine-amidase activity as the majority of serine fibrinogenases. The Km value was determined for β-chain fibrinogenolytic activity: Km = 8.3 μM. Kinetic parameters for amidase activity were also determined. Amino-acid composition was revealed. Limited hydrolysis of fibrinogen by the obtained fibrinogenase allowed us to detemine stable hydrolytic subproducts with definite molecular weights. The manner of the proteolytic processes suggests possible use of this fibrinogenase in probing fibrinogen structure dinamics by limited proteolysis. Applicability of the obtained fibrinogenase in therapeutic practice is speculative, but presented data about its nature are encouraging and require additional investigation.展开更多
AIM To investigate the prognostic value of the combination of preoperative plasma fibrinogen and CA199 in patients with gallbladder carcinoma(GBC).METHODS The clinicopathological data of 154 GBC patients were retrospe...AIM To investigate the prognostic value of the combination of preoperative plasma fibrinogen and CA199 in patients with gallbladder carcinoma(GBC).METHODS The clinicopathological data of 154 GBC patients were retrospectively reviewed after surgery. A receiver operating characteristic(ROC) curve was plotted to verify the optimum cut-off values for plasma fibrinogen and CA199. Univariate and multivariate survival analyses were performed to identify the factors associated with GBC prognosis. based on the HRs calculated via multivariate survival analyses, patients with elevated plasma fibrinogen and CA199 levels were allocated a score of 2.1; those with an elevated plasma fibrinogen level only were allocated a score of 1, those with an elevated CA199 level only were allocated a score of 1.1, and those with neither of these abnormalities were allocated a score of 0.RESULTS ROC curve analysis showed that the optimum cut-off values for preoperative plasma fibrinogen and CA199 were 3.47 g/L and 25.45 U/mL, respectively. Multivariate analysis indicated that elevated preoperative plasma fibrinogen and CA199 levels were significantly correlated with worse overall survival(OS)(HR = 1.711, 95%CI: 1.114-2.627, P = 0.014, and HR = 1.842, 95%CI: 1.111-3.056, P = 0.018). When we combined these two parameters, the area under the ROC curve increased from 0.735(for preoperative plasma fibrinogen only) and 0.729(for preoperative CA199 only) to 0.765. When this combined variable was added to the multivariate analysis, the combination of plasma fibrinogen and CA199(P < 0.001), resection margin(P < 0.001) and TNM stage(P = 0.010) were independent prognostic factors for GBC.CONCLUSION The combination of plasma fibrinogen and CA199 may serve as a more efficient independent prognostic biomarker for postoperative GBC patients than either parameter alone.展开更多
AIM:To investigate the prognostic significance of preoperative fibrinogen levels in colon cancer patients.METHODS:A total of 255 colon cancer patients treated at the Affiliated Tumor Hospital of Xinjiang Medical Unive...AIM:To investigate the prognostic significance of preoperative fibrinogen levels in colon cancer patients.METHODS:A total of 255 colon cancer patients treated at the Affiliated Tumor Hospital of Xinjiang Medical University from June 1st 2005 to June 1st 2008 were enrolled in the study.All patients received radical surgery as their primary treatment method.Preoperative fibrinogen was detected by the Clauss method,and all patients were followed up after surgery.Preoperative fibrinogen measurements were correlated with a number of clinicopathological parameters using the Student t test and analysis of variance.Survival analyses were performed by the Kaplan-Meier method and Cox regression modeling to measure 5-year disease-free survival(DFS)and overall survival(OS).RESULTS:The mean preoperative fibrinogen concentration of all colon cancer patients was 3.17±0.88 g/L.Statistically significant differences were found between preoperative fibrinogen levels and the clinicopathological parameters of age,smoking status,tumor size,tumor location,tumor-node-metastasis(TNM)stage,modified Glasgow prognostic scores(mGPS),white blood cell(WBC)count,neutrophil-lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR),and carcinoembryonic antigen(CEA)levels.Univariate survival analysis showed that TNM stage,tumor cell differentiation grade,vascular invasion,mGPS score,preoperative fibrinogen,WBC,NLR,PLR and CEA all correlated with both OS and DFS.Alpha-fetoprotein(AFP)and body mass index correlated only with OS.Kaplan-Meier analysis revealed that both OS and DFS of the total cohort,as well as of the stageⅡandⅢpatients,were higher in the hypofibrinogen group compared to the hyperfibrinogen group(all P<0.05).In contrast,there was no significant difference between OS and DFS in stageⅠpatients with low or high fibrinogen levels.Cox regression analysis indicated preoperative fibrinogen levels,TNM stage,mGPS score,CEA,and AFP levels correlated with both OS and DFS.CONCLUSION:Preoperative fibrinogen levels can serve as an independent prognostic marker to evaluate patient response to colon cancer treatment.展开更多
BACKGROUND: There have been few reports on the clinical significance of the fibrinogen degradation product(FDP) level in trauma patients with and without head injury. We retrospectively analyzed trauma patients with o...BACKGROUND: There have been few reports on the clinical significance of the fibrinogen degradation product(FDP) level in trauma patients with and without head injury. We retrospectively analyzed trauma patients with or without head injury to investigate the clinical signifi cance of the FDP level.METHODS: From April 2013 to June 2015, a medical chart review was retrospectively performed for all patients with trauma. The exclusion criteria included patients who did not receive a transfusion. The patients were divided into two groups: a FDP>100 group, which included patients who had an FDP level on arrival over 100 ng/m L, and a FDP≤100 group.RESULTS: The ratio of open fractures and the prothrombin ratio in the FDP>100 group were significantly smaller than those observed in the FDP≤100 group. The average age, ratio of blunt injury, Injury Severity Score(ISS), volume of transfusion and mortality ratio in the FDP>100 group were signifi cantly greater than those in the FDP≤100 group. There was a weakly positive correlation between the FDP level and ISS(R=0.35, P=0.002), but it was not associated with the transfusion volume. The results of an analysis excluding patients with head injury showed a similar tendency.CONCLUSION: The FDP levels may be a useful biochemical parameter for the initial evaluation of the severity of trauma and mortality even in blunt traumatized patients without head injury or with stable vital signs.展开更多
BACKGROUND Patients with malignant tumors frequently exhibit hyperactivation of the coagulation system and secondary increased fibrinolytic activity.Fibrinogen and D-dimer are common indicators that are crucial in the...BACKGROUND Patients with malignant tumors frequently exhibit hyperactivation of the coagulation system and secondary increased fibrinolytic activity.Fibrinogen and D-dimer are common indicators that are crucial in the coagulation/fibrinolysis system.Both indicators have been verified to have predictive value in the overall survival(OS)of many patients with solid malignancies.AIM To explore the prognostic significance of fibrinogen combined with D-dimer in pancreatic ductal adenocarcinoma(PDAC)patients undergoing radical R0 resection.METHODS We retrospectively analyzed the clinical data of 282 patients with PDAC undergoing radical R0 resection in the Cancer Hospital,Chinese Academy of Medical Sciences,between January 2010 and December 2019.The surv_cutpoint function of R language was used to determine the optimal cutoff values of the preoperative fibrinogen concentration and preoperative D-dimer concentration.Enrolled patients were further divided into the any-high group(high preoperative fibrinogen concentration and/or high preoperative D-dimer concentration)and the low-low group(low preoperative fibrinogen and D-dimer concentrations)according to the optimal cutoff values.RESULTS The optimal cutoff values of the preoperative fibrinogen concentration and preoperative D-dimer concentration were 3.31 g/L and 0.53 mg/L,respectively.Furthermore,multivariate Cox regression analysis showed that the preoperative fibrinogen concentration(HR:1.603,95%CI:1.201-2.140,P=0.001)and preoperative D-dimer concentration(HR:1.355,95%CI:1.019-1.801,P=0.036)exhibited obvious correlations with the OS of PDAC patients undergoing radical R0 resection.A prognostic analysis was further performed based on the subgroup results by using fibrinogen combined with D-dimer.The median OS duration of the low-low group(31.17 mo)was significantly longer than that of the any-high group(15.43 mo).Additionally,multivariate Cox regression analysis revealed that the degree of differentiation(P<0.001),lymph node metastasis(HR:0.663,95%CI:0.497-0.883,P=0.005),preoperative CA19-9 level(HR:1.699,95%CI:1.258-2.293,P=0.001),adjuvant therapy(HR:1.582,95%CI:1.202-2.081,P=0.001)and preoperative combined grouping(HR:2.397,95%CI:1.723-3.335,P<0.001)were independent predictors of OS in PDAC patients undergoing radical R0 resection.CONCLUSION Preoperative fibrinogen combined with D-dimer plays a predictive role in OS,and low preoperative fibrinogen and D-dimer concentrations can indicate prolonged OS in PDAC patients undergoing radical R0 resection.展开更多
AIM: To examine fibrinogen-like protein 2 (fgl2) expression during taurocholate-induced acute pancreatitis progression in rats and its correlation with pancreatic injury severity. METHODS: Forty-eight male Sprague-Daw...AIM: To examine fibrinogen-like protein 2 (fgl2) expression during taurocholate-induced acute pancreatitis progression in rats and its correlation with pancreatic injury severity. METHODS: Forty-eight male Sprague-Dawley rats were randomly divided into the severe acute pancreatitis (SAP) group (n = 24) and the sham operation (SO) group (n = 24). Sodium taurocholate (4% at doses of 1 mL/kg body weight) was retrogradely injected into the biliopancreatic ducts of the rats to induce SAP. Pancreatic tissues were prepared immediately after sacrifice. At the time of sacrifice, blood was obtained for determination of serum amylase activity and isolation of peripheral blood mononuclear cells (PBMCs). Pancreatic tissue specimens were obtained for routine light microscopy including hematoxylin and eosin staining, and the severity of pancreatic injury was evaluated 1, 4 and 8 h after induction. Expression of fgl2 mRNA was measured in the pancreas and PBMCs using reverse transcription polymerase chain reaction. Expression of fgl2 protein was evaluated in pancreatic tissues using Western blotting and immunohistochemical staining. Masson staining was also performed to observe microthrombosis. RESULTS: At each time point, levels of fgl2 mRNAs in pancreatic tissues and PBMCs were higher (P < 0.05) in the SAP group than in the SO group. For pancreatic tissue in SAP vs SO, the levels were: after 1 h, 3.911 ± 1.277 vs 1.000 ± 0.673; after 4 h, 9.850 ± 3.095 vs 1.136 ± 0.609; and after 8 h, 12.870 ± 3.046 vs 1.177 ± 0.458. For PBMCs in SAP vs SO, the levels were: after 1 h, 2.678 ± 1.509 vs 1.000 ± 0.965; after 4 h, 6.922 ± 1.984 vs 1.051 ± 0.781; and after 8 h, 13.533 ± 6.575 vs 1.306 ± 1.179. Levels of fgl2 protein expression as determined by Western blotting and immunohistochemical staining were markedly up-regulated (P < 0.001) in the SAP group compared with those in the SO group. For Western blotting in SAP vs SO, the results were: after 1 h, 2.183 ± 0.115 vs 1.110 ± 0.158; after 4 h, 2.697 ± 0.090 vs 0.947 ± 0.361; and after 8 h, 3.258 ± 0.094 vs 1.208 ± 0.082. For immunohistochemical staining in SAP vs SO, the results were: after 1 h, 1.793 ± 0.463 vs 0.808 ± 0.252; after 4 h, 4.535 ± 0.550 vs 0.871 ± 0.318; and after 8 h, 6.071 ± 0.941 vs 1.020 ± 0.406. Moreover, we observed a positive correlation in the pancreas (r = 0.852, P < 0.001) and PBMCs (r = 0.735, P < 0.001) between fgl2 expression and the severity of pancreatic injury. Masson staining showed that microthrombosis (%) in rats with SAP was increased (P < 0.001) compared with that in the SO group and it was closely correlated with fgl2 expression in the pancreas (r = 0.842, P < 0.001). For Masson staining in SAP vs SO, the results were: after 1 h, 26.880 ± 9.031 vs 8.630 ± 3.739; after 4 h, 53.750 ± 19.039 vs 8.500 ± 4.472; and after 8 h, 80.250 ± 12.915 vs 10.630 ± 7.003.CONCLUSION: Microthrombosis due to fgl2 overexpression contributes to pancreatic impairment in rats with SAP, and fgl2 level may serve as a biomarker during early stages of disease.展开更多
Objective The aim of this study was to investigate the correlation between pretreatment fibrinogen levels and metastasis in non-small cell lung cancer(NSCLC).Methods The study included 503 NSCLC patients with a clear ...Objective The aim of this study was to investigate the correlation between pretreatment fibrinogen levels and metastasis in non-small cell lung cancer(NSCLC).Methods The study included 503 NSCLC patients with a clear pathological diagnosis and 168 patients diagnosed with benign lung diseases by histological examination.Pretreatment plasma fibrinogen values were quantified,and the relationship between plasma fibrinogen level and clinical variables comprising tumor size,metastasis,and clinical stage was examined using Kruskal-Wallis test,Wilcoxon rank sum test,and Chi-square test.Results The median plasma fibrinogen values were statistically higher in NSCLC patients with metastasis than patients with benign lung diseases and NSCLC patients without metastasis(Kruskal-Wallis test;P<0.001).Plasma fibrinogen values were also significantly higher in advanced clinical stages(Wilcoxon rank sum test;P<0.001).A significant relationship was observed between elevated fibrinogen(>2.974 g/L)and metastasis,clinical stage,and tumor size(Chi-square test;P<0.001).Conclusion This correlation suggests that elevated pretreatment plasma fibrinogen levels can predict metastasis and advanced tumor stage in NSCLC patients.展开更多
Fibrinogen-like 2(FGL2) encompasses a transmembrane(m FGL2) and a soluble(s FGL2) form with differential tertiary structure and biological activities. Typically, m FGL2 functions as prothrombinase that is capable of i...Fibrinogen-like 2(FGL2) encompasses a transmembrane(m FGL2) and a soluble(s FGL2) form with differential tertiary structure and biological activities. Typically, m FGL2 functions as prothrombinase that is capable of initiating coagulation in tissue without activation of the blood clotting cascade, whereas s FGL2 largely acts as an immunosuppressor that can repress proliferation of alloreactive T lymphocytes and maturation of bone marrow dendritic cells. Protein sequences of FGL2 exhibit evolutionary conservation across wide variety of species, especially at the carboxyl terminus that contains fibrinogen related domain(FRED). The FRED of FGL2 confers specificity and complexity in the action of FGL2, including receptor recognition, calcium affiliation, and substrate binding. Constitutive expression of FGL2 during embryogenesis and in mature tissues suggests FGL2 might be physiologically important. However, excessive induction of FGL2 under certain medical conditions(e.g. pathogen invasion) could trigger complement activation, inflammatory response,cellular apoptosis, and immune dysfunctions. On the other hand, complete absence of FGL2 is also detrimental as lack of FGL2 can cause autoimmune glomerulonephritis and acute cellular rejection of xenografts. All these roles involve m FGL2, s FGL2, or their combination. Although it is not clear how m FGL2 is cleaved off its host cells and secreted into the blood, circulating s FGL2 has been found correlated with disease severity and viral loading among patients with human hepatitis B virus or hepatitis C virus infection. Further studies are warranted to understand how FGL2 expression is regulated under physiological and pathological conditions. Even more interesting is to determine whether m FGL2 can fulfill an immunoregulatory role through its FRED at carboxyl end of the molecule and, and vice versa, whether s FGL2 is procoagulant upon binding to a target cell. Knowledge in this area should shed light on development of s FGL2 as an alternative immunosuppressive agent for organ transplantation or as a biomarker for predicting disease progression, monitoring therapeutic effects, and targeting FGL2 for repression in ameliorating fulminant viral hepatitis.展开更多
Objective This study aimed to elucidate the association between the level of preoperative serum fibrinogen(PSF)and the prognosis of patients with esophageal squamous cell carcinoma(ESCC).Methods From January 2010 to D...Objective This study aimed to elucidate the association between the level of preoperative serum fibrinogen(PSF)and the prognosis of patients with esophageal squamous cell carcinoma(ESCC).Methods From January 2010 to December 2016,all patients diagnosed with ESCC who underwent surgery in Qingdao Municipal Hospital were analyzed retrospectively.Moreover,the fibrinogen levels of all patients were assessed before surgery,and hyperfibrinogenemia was diagnosed when the fibrinogen level was≥4.0 g/L.The impact of PSF on disease-free survival(DFS)and overall survival(OS)was analyzed using the log-rank method and Cox proportional hazards regression model.P value less than 0.05 was considered statistically significant.Results A total of 336 patients were finally analyzed,and approximately 102 patients(30.36%)were diagnosed with hyperfibrinogenemia before surgery.Hyperfibrinogenemia was associated with older age(≥70 years)(P=0.012),advanced pathological T stage(P=0.003),and lymph node involvement(P=0.024).Univariate analysis showed that patients with hyperfibrinogenemia had shorter DFS(1.96 years vs.3.64 years,P=0.001)and OS(2.27 years vs.4.15 years,P<0.001)than patients without hyperfibrinogenemia.Multivariate analysis confirmed that PSF was an independent factor affecting DFS(risk ratio[RR]:1.35,95%confidence interval[CI]:1.02-1.79,P=0.038)and OS(RR:1.37,95%CI:1.03-1.83,P=0.034)in patients with ESCC.Conclusion For patients with operable ESCC,hyperfibrinogenemia had poor prognosis.Moreover,PSF is an independent prognostic factor for operable ESCC.展开更多
基金the National Natural Science Foundation of China,No.8236110677Central to guide local scientific and Technological Development,No.ZYYDDFFZZJ-1+1 种基金Natural Science Foundation of Gansu Province,China,No.18JR2RA033Gansu Da Vinci Robot High-End Diagnosis and Treatment Team Construction Project,National Key Research and Development Program,No.2020RCXM076.
文摘BACKGROUND Gastric cancer has a high incidence and fatality rate,and surgery is the preferred course of treatment.Nonetheless,patient survival rates are still low,and the incidence of major postoperative complications cannot be disregarded.The systemic inflammatory response,nutritional level,and coagulation status are key factors affecting the postoperative recovery and prognosis of gastric cancer patients.The systemic inflammatory response index(SIRI)and the albumin fibrinogen ratio(AFR)are two valuable comprehensive indicators of the severity and prognosis of systemic inflammation in various medical conditions.AIM To assess the clinical importance and prognostic significance of the SIRI scores and the AFR on early postoperative outcomes in patients undergoing radical gastric cancer surgery.METHODS We conducted a retrospective analysis of the clinicopathological characteristics and relevant laboratory indices of 568 gastric cancer patients from January 2018 to December 2019.We calculated and compared two indicators of inflammation and then examined the diagnostic ability of combined SIRI and AFR values for serious early postoperative complications.We scored the patients and categorized them into three groups based on their SIRI and AFR levels.COX analysis was used to compare the three groups of patients the prognostic value of various preoperative SIRI-AFR scores for 5-year overall survival(OS)and disease-free survival(DFS).RESULTS SIRI-AFR scores were an independent risk factor for prognosis[OS:P=0.004;hazards ratio(HR)=3.134;DFS:P<0.001;HR=3.543]and had the highest diagnostic power(area under the curve:0.779;95%confidence interval:0.737-0.820)for early serious complications in patients with gastric cancer.The tumor-node-metastasis stage(P=0.001),perioperative transfusion(P=0.044),positive carcinoembryonic antigen(P=0.014)findings,and major postoperative complications(P=0.011)were factors associated with prognosis.CONCLUSION Preoperative SIRI and AFR values were significantly associated with early postoperative survival and the occurrence of severe complications in gastric cancer patients.
基金American college of Cardiology,No.3445007European society of Cardiology,No.1036629.
文摘BACKGROUND Coronavirus disease 2019(COVID-19)pandemic unmasked the huge deficit in healthcare resources worldwide.It highlighted the need for efficient risk stratification in management of cardiovascular emergencies.AIM To study the applicability of the old,available and affordable nonconventional biomarkers:albumin and fibrinogen in their ability to predict angiographic severity and clinical outcomes in patients with acute coronary syndrome(ACS).METHODS In this prospective,observational study,166 consecutive patients with ACS were enrolled.Fibrinogen,albumin and their ratio were determined from serum.Patients with underlying chronic liver disease,active malignancy,autoimmune disease,active COVID-19 infection and undergoing thrombolysis were excluded.RESULTS Mean age of the population was 60.5±1.5 years,74.1%being males.ST elevation myocardial infarction(STEMI)was most common presentation of ACS seen in 57%patients.Fibrinogen albumin ratio(FAR)≥19.2,had a sensitivity of 76.9%and specificity of 78.9%[area under the receiver operating characteristic curves(AUROC)=0.8,P=0.001]to predict≤thrombolysis in myocardial infarction(TIMI)1 flow in culprit artery in STEMI patients.Even in non-STEMI patients,FAR≥18.85 predicted the same with 80%sensitivity and 63%specificity(AUROC=0.715,P=0.006).CONCLUSION Novel biomarkers,with their high cost,lack of availability and long turn over time are impractical for real-world use.Identifying≤TIMI 1 flow in the culprit artery has significant impact of management and outcome.Our study has shown that readily available biomarkers like fibrinogen and albumin can help identify these high-risk patients with good accuracy.This allows risk-stratification and individualization of treatment in ACS.
基金supported by a National Research Foundation of Korea(NRF)grant funded by the Korean government(MSIT)(NRF-2020R1A2C2011937,2020R1C1C1007129)a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute(KHIDI)funded by the Ministry of Health&Welfare(HI22C1572)R&BD Program through the INNOPOLIS funded by Ministry of Science and ICT(2021-IT-RD-0059-01-101).
文摘Biodegradable hydrogels are promising biomaterials for use in controlled-release systems for skin tissue regeneration. Controlled delivery systems constitute an important aspect of tissue engineering because they can modulate various physiological responses, including early immune response, tissue remodeling, and cell proliferation and maturation in the wound-healing process. Hydrogels composed of various biomaterials have been developed to overcome the limitations of conventional drug- or protein-delivery systems, such as limited targeting ability, low stability, and the induction of drug resistance. Hydrogels based on keratin, a natural polymer extracted from human hair, can provide adequate cell support and control homeostasis. Consequently, they can be applied for skin tissue engineering. In this study, we prepared degradable, tunable, and biocompatible hydrogels for controllable protein delivery. We synthesized keratin-fibrinogen (KER-FBG) by the chemical coupling reaction and prepared hydrogels through polymerization with thrombin. The structures and morphologies of the KER-FBG hydrogels were confirmed. Furthermore, the mechanical properties, swelling ratio, degradation, release behavior, and biocompatibility were investigated. The KER-FBG hydrogels presented promising biological performance, indicating that the material is suitable as a controlled protein delivery carrier.
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Objective:To investigate the effect of heparin on fibrinogen detection by Clauss method.Methods:A normal plasma pool(NPP)of 20 healthy people was prepared with 3.2%sodium citrate anticoagulant.For experimental group 1,samples containing different concentrations of heparin were prepared.For experimental group 2,samples of experimental group 1 were diluted twice.For experimental group 3,samples of experimental group 1 were diluted 4 times.For the control group,samples of normal saline with the same volume as heparin in experimental group 1 were prepared.The fibrinogen contents of experimental group 1,experimental group 2,experimental group 3,and control group were detected by Clauss method and prothrombin time(PT)-derived method,and the fibrinogen detection results of different groups were analyzed.Results:The trend of fibrinogen detected by Clauss method and PT-derived method in experimental group 1 was different;there was significant difference between the results of experimental group 1 and the control group(P<0.05);there was no significant difference between the results of experimental group 2 and the control group(P>0.05);there was no significant difference between the results of experimental group 3 and the control group(P>0.05);there was no significant difference between the results of experimental group 2 and experimental group 3(P>0.05);the relative deviation between experimental group 1 and the control group was higher in high-concentration heparin sample.Conclusion:Heparin affects fibrinogen detection by Clauss method,and the effect can be reduced by sample dilution.
基金Supported by the National key Project research and Development Projects,No.S2016G9012International Science and Technology Cooperation Projects,No.2015DFA30650The Capital Special research Project for Clinical Application,No.Z151100004015170
文摘AIM To investigate the prognostic role of fibrinogen-toalbumin ratio(FAR) on patients with gallbladder cancer(Gbc) in this study.METHODS One hundred and fifty-four Gbc patients were retro-spectively analyzed, who received potentially curative cholecystectomy in our institute from March 2005 to December 2017. Receiver operating characteristic curve(ROc curve) was used to determine the optimal cut-offs for these biomarkers. In addition, Kaplan-Meier survival analysis as well as multivariate analysis were applied for prognostic analyses.RESULTS ROc curve revealed that the optimal cut-off value for FAR was 0.08. FAR was significantly correlated with age(P = 0.045), jaundice(P < 0.001), differentiation(P = 0.002), resection margin status(P < 0.001), T stage(P < 0.001), TNM stage(P < 0.001), and c A199(P < 0.001) as well as albumin levels(P < 0.001). Multivariate analysis indicated that the resection margin status [hazard ratio(HR): 2.343, 95% confidence interval(c I): 1.532-3.581, P < 0.001], TNM stage(P = 0.035), albumin level(HR = 0.595, 95%c I: 0.385-0.921, P = 0.020) and FAR(HR: 2.813, 95%c I: 1.765-4.484, P < 0.001) were independent prognostic factors in Gbc patients.CONCLUSION An elevated preoperative FAR was significantly correlated with unfavorable overall survival in Gbc patients, while an elevated preoperative albumin level was a protective prognostic factor for patients with Gbc. The preoperative FAR could be used to predict the prognosis of Gbc patients, which was easily accessible, costeffective and noninvasive.
文摘Objective Hemocoagulase injection based on the venom of Agkistrodon halys Pallas is widely used in the treatment of hemorrhagic disorders.This study aimed to characterize the clinical laboratory findings of hemocoagulase-induced hypofibrinogenemia as the associated adverse reaction of hemocoagulase injection.Methods Wie retrospectively enrolled 27 in-patients who were treated with hemocoagulase injection for hemoptysis and developed hypofibrinogenemia during the period of January 1,2015 to March 31,2018.Clinical data were collected and investigated,including clinical manifestations,hemostatic and fibrinolytic parameters,dosage of hemocoagulase,the medication time,and the cryoprecipitate blood product infusion.Differences in fibrinogen,D-dimer,and fibrin/fibrinogen degradation products(FDP)before,during,and after the application of hemocoagulase injection were analyzed statistically.Results Plasma fibrinogen level during medication of hemocoagulase injection decreased significantly compared to that before the treatment(F=1.80,P<0.001),with the average decrease of 2.28 g/L(0.63-3.9 g/L).After withdrawal,fibrinogen level increased significantly compared to that during the medication(F=l.20,P<0.001),but was still lower than that before the medication(F=0.59,P=0.03).The D-dimer level and the FDP level after withdrawal decreased significantly compared to the levels during the medication(F=0.83,P=0.002;Wilcoxon-test,Z=-4.54,P<0.001).Spearman's correlation analyses did not find either fibrinogen change during-before the administration or FDP change after-during the administration was associated with the dosage of hemo coagulase(r=-0.17,P=0.40;r=-0.28,P=0.15;respectively)and the time of recovery from hypofibrinogenemia(r=-0.45,P=0.05;r=0.13,P=0.61;respectively).Conclusion Monitoring both clotting and fibrinolysis parameters is essential in the management of hemoptysis patients treated with hemocoagulase injection.Clinicians should be aware of hypofibrinogenemia and consider discontinuation of the administration of hemocoagulase whenever necessary.
文摘BACKGROUND Venom-induced consumption coagulopathy(VICC)is characterized by coagulation dysfunction accompanied by decreased coagulation factor activity and fibrinogen(FBG)concentrations.We report a patient with VICC caused by snake bite who manifested persistent FBG deficiency without abnormal coagulation factor activity.This information may be helpful in diagnosing and treating VICC.CASE SUMMARY A 49-year-old man who had been bitten by a snake 13 h previously was admitted to the Emergency Department of our hospital with visible swelling of a finger and a bleeding puncture site.The provisional diagnosis was VICC,this being made based on persistent bleeding from the puncture site and subcutaneous hemorrhage.Laboratory evidence of coagulation abnormalities,including fibrinolysis,and findings on thromboelastography confirmed VICC.He had persistent afibrinogenemia requiring intravenous infusions of cryoprecipitate and fresh frozen plasma,together with continuous large doses of human FBG.After this treatment,the patient’s right upper limb swelling improved significantly and his subcutaneous hemorrhage resolved.All of his abnormal laboratory findings returned to normal by day 25.During 6 months’of follow-up,the patient had no further hemorrhagic events.CONCLUSION Hemorrhagic snake venom can result in coagulation dysfunction characterized by persistent FBG deficiency without abnormal coagulation factor activity.
基金Natural Science Fund of Jilin Province,No.YDZJ202201ZYTS278.
文摘BACKGROUND The purpose of this study was to report the rare case of a pregnant woman with congenital dysfibrinogenemia(CD)misdiagnosed as acute fatty liver.She was treated according to the principles of acute fatty liver but achieved good clinical results.CASE SUMMARY A 30-year-old woman presented with 39(6/7)wk of menopause and 6 h of irregular abdominal pain and attended our hospital.Emergency surgery was performed due to fetal distress.Postoperative management followed the treatment principle of acute fatty liver.DNA sequencing was carried out on the pregnant woman and her pedigree.Coagulation values of the patient on admission were prothrombin time 33.7 s,activated partial thromboplastin time 60.4 s,thrombin time 45.2 s,and fibrinogen 0.60 g/L.DNA sequencing results showed that the woman carried a pathogenic heterozygous variation of the fibrinogen alpha chain gene(FGA),which is closely related to hereditary fibrinogen abnormality,and the mutation site was located in p.R350H.After a follow-up period of 12 mo,the mother and her newborn had a good prognosis without bleeding or thrombosis.CONCLUSION Pregnant women with CD may have atypical symptoms,which can easily lead to misdiagnosis.In addition,treatment can be attempted according to the principles of acute fatty liver management.This rare pregnant patient with CD was caused by a novel FGA(p.R350H)gene mutation.
文摘A serine proteinase with a fibrinogenase activity was isolated from the venom of viper Echis multisquamatis. Isolation was performed by the combination of Q-sepharose and Heparine-agarose chromatography. The enzyme has apparent molecular weight 35 ± 1 kDа. It posesses strong fibrinogen β-chain, moderate αchain proteolytic activity, arginine-amidase activity as the majority of serine fibrinogenases. The Km value was determined for β-chain fibrinogenolytic activity: Km = 8.3 μM. Kinetic parameters for amidase activity were also determined. Amino-acid composition was revealed. Limited hydrolysis of fibrinogen by the obtained fibrinogenase allowed us to detemine stable hydrolytic subproducts with definite molecular weights. The manner of the proteolytic processes suggests possible use of this fibrinogenase in probing fibrinogen structure dinamics by limited proteolysis. Applicability of the obtained fibrinogenase in therapeutic practice is speculative, but presented data about its nature are encouraging and require additional investigation.
基金Supported by National key Project research and Development Projects,No.S2016G9012International Science and Technology Cooperation Projects,No.2015DFA30650The Capital Special research Project for Clinical Application,No.Z151100004015170
文摘AIM To investigate the prognostic value of the combination of preoperative plasma fibrinogen and CA199 in patients with gallbladder carcinoma(GBC).METHODS The clinicopathological data of 154 GBC patients were retrospectively reviewed after surgery. A receiver operating characteristic(ROC) curve was plotted to verify the optimum cut-off values for plasma fibrinogen and CA199. Univariate and multivariate survival analyses were performed to identify the factors associated with GBC prognosis. based on the HRs calculated via multivariate survival analyses, patients with elevated plasma fibrinogen and CA199 levels were allocated a score of 2.1; those with an elevated plasma fibrinogen level only were allocated a score of 1, those with an elevated CA199 level only were allocated a score of 1.1, and those with neither of these abnormalities were allocated a score of 0.RESULTS ROC curve analysis showed that the optimum cut-off values for preoperative plasma fibrinogen and CA199 were 3.47 g/L and 25.45 U/mL, respectively. Multivariate analysis indicated that elevated preoperative plasma fibrinogen and CA199 levels were significantly correlated with worse overall survival(OS)(HR = 1.711, 95%CI: 1.114-2.627, P = 0.014, and HR = 1.842, 95%CI: 1.111-3.056, P = 0.018). When we combined these two parameters, the area under the ROC curve increased from 0.735(for preoperative plasma fibrinogen only) and 0.729(for preoperative CA199 only) to 0.765. When this combined variable was added to the multivariate analysis, the combination of plasma fibrinogen and CA199(P < 0.001), resection margin(P < 0.001) and TNM stage(P = 0.010) were independent prognostic factors for GBC.CONCLUSION The combination of plasma fibrinogen and CA199 may serve as a more efficient independent prognostic biomarker for postoperative GBC patients than either parameter alone.
基金Supported by The Science and Technology Innovation Fund of Xinjiang Medical University,No.XJC201267
文摘AIM:To investigate the prognostic significance of preoperative fibrinogen levels in colon cancer patients.METHODS:A total of 255 colon cancer patients treated at the Affiliated Tumor Hospital of Xinjiang Medical University from June 1st 2005 to June 1st 2008 were enrolled in the study.All patients received radical surgery as their primary treatment method.Preoperative fibrinogen was detected by the Clauss method,and all patients were followed up after surgery.Preoperative fibrinogen measurements were correlated with a number of clinicopathological parameters using the Student t test and analysis of variance.Survival analyses were performed by the Kaplan-Meier method and Cox regression modeling to measure 5-year disease-free survival(DFS)and overall survival(OS).RESULTS:The mean preoperative fibrinogen concentration of all colon cancer patients was 3.17±0.88 g/L.Statistically significant differences were found between preoperative fibrinogen levels and the clinicopathological parameters of age,smoking status,tumor size,tumor location,tumor-node-metastasis(TNM)stage,modified Glasgow prognostic scores(mGPS),white blood cell(WBC)count,neutrophil-lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR),and carcinoembryonic antigen(CEA)levels.Univariate survival analysis showed that TNM stage,tumor cell differentiation grade,vascular invasion,mGPS score,preoperative fibrinogen,WBC,NLR,PLR and CEA all correlated with both OS and DFS.Alpha-fetoprotein(AFP)and body mass index correlated only with OS.Kaplan-Meier analysis revealed that both OS and DFS of the total cohort,as well as of the stageⅡandⅢpatients,were higher in the hypofibrinogen group compared to the hyperfibrinogen group(all P<0.05).In contrast,there was no significant difference between OS and DFS in stageⅠpatients with low or high fibrinogen levels.Cox regression analysis indicated preoperative fibrinogen levels,TNM stage,mGPS score,CEA,and AFP levels correlated with both OS and DFS.CONCLUSION:Preoperative fibrinogen levels can serve as an independent prognostic marker to evaluate patient response to colon cancer treatment.
文摘BACKGROUND: There have been few reports on the clinical significance of the fibrinogen degradation product(FDP) level in trauma patients with and without head injury. We retrospectively analyzed trauma patients with or without head injury to investigate the clinical signifi cance of the FDP level.METHODS: From April 2013 to June 2015, a medical chart review was retrospectively performed for all patients with trauma. The exclusion criteria included patients who did not receive a transfusion. The patients were divided into two groups: a FDP>100 group, which included patients who had an FDP level on arrival over 100 ng/m L, and a FDP≤100 group.RESULTS: The ratio of open fractures and the prothrombin ratio in the FDP>100 group were significantly smaller than those observed in the FDP≤100 group. The average age, ratio of blunt injury, Injury Severity Score(ISS), volume of transfusion and mortality ratio in the FDP>100 group were signifi cantly greater than those in the FDP≤100 group. There was a weakly positive correlation between the FDP level and ISS(R=0.35, P=0.002), but it was not associated with the transfusion volume. The results of an analysis excluding patients with head injury showed a similar tendency.CONCLUSION: The FDP levels may be a useful biochemical parameter for the initial evaluation of the severity of trauma and mortality even in blunt traumatized patients without head injury or with stable vital signs.
基金Supported by the National Natural Science Foundation of China,No.81972314and the Innovation Fund for Medical Sciences of Chinese Academy of Medical Sciences,No.2016-I2M-1-001.
文摘BACKGROUND Patients with malignant tumors frequently exhibit hyperactivation of the coagulation system and secondary increased fibrinolytic activity.Fibrinogen and D-dimer are common indicators that are crucial in the coagulation/fibrinolysis system.Both indicators have been verified to have predictive value in the overall survival(OS)of many patients with solid malignancies.AIM To explore the prognostic significance of fibrinogen combined with D-dimer in pancreatic ductal adenocarcinoma(PDAC)patients undergoing radical R0 resection.METHODS We retrospectively analyzed the clinical data of 282 patients with PDAC undergoing radical R0 resection in the Cancer Hospital,Chinese Academy of Medical Sciences,between January 2010 and December 2019.The surv_cutpoint function of R language was used to determine the optimal cutoff values of the preoperative fibrinogen concentration and preoperative D-dimer concentration.Enrolled patients were further divided into the any-high group(high preoperative fibrinogen concentration and/or high preoperative D-dimer concentration)and the low-low group(low preoperative fibrinogen and D-dimer concentrations)according to the optimal cutoff values.RESULTS The optimal cutoff values of the preoperative fibrinogen concentration and preoperative D-dimer concentration were 3.31 g/L and 0.53 mg/L,respectively.Furthermore,multivariate Cox regression analysis showed that the preoperative fibrinogen concentration(HR:1.603,95%CI:1.201-2.140,P=0.001)and preoperative D-dimer concentration(HR:1.355,95%CI:1.019-1.801,P=0.036)exhibited obvious correlations with the OS of PDAC patients undergoing radical R0 resection.A prognostic analysis was further performed based on the subgroup results by using fibrinogen combined with D-dimer.The median OS duration of the low-low group(31.17 mo)was significantly longer than that of the any-high group(15.43 mo).Additionally,multivariate Cox regression analysis revealed that the degree of differentiation(P<0.001),lymph node metastasis(HR:0.663,95%CI:0.497-0.883,P=0.005),preoperative CA19-9 level(HR:1.699,95%CI:1.258-2.293,P=0.001),adjuvant therapy(HR:1.582,95%CI:1.202-2.081,P=0.001)and preoperative combined grouping(HR:2.397,95%CI:1.723-3.335,P<0.001)were independent predictors of OS in PDAC patients undergoing radical R0 resection.CONCLUSION Preoperative fibrinogen combined with D-dimer plays a predictive role in OS,and low preoperative fibrinogen and D-dimer concentrations can indicate prolonged OS in PDAC patients undergoing radical R0 resection.
文摘AIM: To examine fibrinogen-like protein 2 (fgl2) expression during taurocholate-induced acute pancreatitis progression in rats and its correlation with pancreatic injury severity. METHODS: Forty-eight male Sprague-Dawley rats were randomly divided into the severe acute pancreatitis (SAP) group (n = 24) and the sham operation (SO) group (n = 24). Sodium taurocholate (4% at doses of 1 mL/kg body weight) was retrogradely injected into the biliopancreatic ducts of the rats to induce SAP. Pancreatic tissues were prepared immediately after sacrifice. At the time of sacrifice, blood was obtained for determination of serum amylase activity and isolation of peripheral blood mononuclear cells (PBMCs). Pancreatic tissue specimens were obtained for routine light microscopy including hematoxylin and eosin staining, and the severity of pancreatic injury was evaluated 1, 4 and 8 h after induction. Expression of fgl2 mRNA was measured in the pancreas and PBMCs using reverse transcription polymerase chain reaction. Expression of fgl2 protein was evaluated in pancreatic tissues using Western blotting and immunohistochemical staining. Masson staining was also performed to observe microthrombosis. RESULTS: At each time point, levels of fgl2 mRNAs in pancreatic tissues and PBMCs were higher (P < 0.05) in the SAP group than in the SO group. For pancreatic tissue in SAP vs SO, the levels were: after 1 h, 3.911 ± 1.277 vs 1.000 ± 0.673; after 4 h, 9.850 ± 3.095 vs 1.136 ± 0.609; and after 8 h, 12.870 ± 3.046 vs 1.177 ± 0.458. For PBMCs in SAP vs SO, the levels were: after 1 h, 2.678 ± 1.509 vs 1.000 ± 0.965; after 4 h, 6.922 ± 1.984 vs 1.051 ± 0.781; and after 8 h, 13.533 ± 6.575 vs 1.306 ± 1.179. Levels of fgl2 protein expression as determined by Western blotting and immunohistochemical staining were markedly up-regulated (P < 0.001) in the SAP group compared with those in the SO group. For Western blotting in SAP vs SO, the results were: after 1 h, 2.183 ± 0.115 vs 1.110 ± 0.158; after 4 h, 2.697 ± 0.090 vs 0.947 ± 0.361; and after 8 h, 3.258 ± 0.094 vs 1.208 ± 0.082. For immunohistochemical staining in SAP vs SO, the results were: after 1 h, 1.793 ± 0.463 vs 0.808 ± 0.252; after 4 h, 4.535 ± 0.550 vs 0.871 ± 0.318; and after 8 h, 6.071 ± 0.941 vs 1.020 ± 0.406. Moreover, we observed a positive correlation in the pancreas (r = 0.852, P < 0.001) and PBMCs (r = 0.735, P < 0.001) between fgl2 expression and the severity of pancreatic injury. Masson staining showed that microthrombosis (%) in rats with SAP was increased (P < 0.001) compared with that in the SO group and it was closely correlated with fgl2 expression in the pancreas (r = 0.842, P < 0.001). For Masson staining in SAP vs SO, the results were: after 1 h, 26.880 ± 9.031 vs 8.630 ± 3.739; after 4 h, 53.750 ± 19.039 vs 8.500 ± 4.472; and after 8 h, 80.250 ± 12.915 vs 10.630 ± 7.003.CONCLUSION: Microthrombosis due to fgl2 overexpression contributes to pancreatic impairment in rats with SAP, and fgl2 level may serve as a biomarker during early stages of disease.
文摘Objective The aim of this study was to investigate the correlation between pretreatment fibrinogen levels and metastasis in non-small cell lung cancer(NSCLC).Methods The study included 503 NSCLC patients with a clear pathological diagnosis and 168 patients diagnosed with benign lung diseases by histological examination.Pretreatment plasma fibrinogen values were quantified,and the relationship between plasma fibrinogen level and clinical variables comprising tumor size,metastasis,and clinical stage was examined using Kruskal-Wallis test,Wilcoxon rank sum test,and Chi-square test.Results The median plasma fibrinogen values were statistically higher in NSCLC patients with metastasis than patients with benign lung diseases and NSCLC patients without metastasis(Kruskal-Wallis test;P<0.001).Plasma fibrinogen values were also significantly higher in advanced clinical stages(Wilcoxon rank sum test;P<0.001).A significant relationship was observed between elevated fibrinogen(>2.974 g/L)and metastasis,clinical stage,and tumor size(Chi-square test;P<0.001).Conclusion This correlation suggests that elevated pretreatment plasma fibrinogen levels can predict metastasis and advanced tumor stage in NSCLC patients.
文摘Fibrinogen-like 2(FGL2) encompasses a transmembrane(m FGL2) and a soluble(s FGL2) form with differential tertiary structure and biological activities. Typically, m FGL2 functions as prothrombinase that is capable of initiating coagulation in tissue without activation of the blood clotting cascade, whereas s FGL2 largely acts as an immunosuppressor that can repress proliferation of alloreactive T lymphocytes and maturation of bone marrow dendritic cells. Protein sequences of FGL2 exhibit evolutionary conservation across wide variety of species, especially at the carboxyl terminus that contains fibrinogen related domain(FRED). The FRED of FGL2 confers specificity and complexity in the action of FGL2, including receptor recognition, calcium affiliation, and substrate binding. Constitutive expression of FGL2 during embryogenesis and in mature tissues suggests FGL2 might be physiologically important. However, excessive induction of FGL2 under certain medical conditions(e.g. pathogen invasion) could trigger complement activation, inflammatory response,cellular apoptosis, and immune dysfunctions. On the other hand, complete absence of FGL2 is also detrimental as lack of FGL2 can cause autoimmune glomerulonephritis and acute cellular rejection of xenografts. All these roles involve m FGL2, s FGL2, or their combination. Although it is not clear how m FGL2 is cleaved off its host cells and secreted into the blood, circulating s FGL2 has been found correlated with disease severity and viral loading among patients with human hepatitis B virus or hepatitis C virus infection. Further studies are warranted to understand how FGL2 expression is regulated under physiological and pathological conditions. Even more interesting is to determine whether m FGL2 can fulfill an immunoregulatory role through its FRED at carboxyl end of the molecule and, and vice versa, whether s FGL2 is procoagulant upon binding to a target cell. Knowledge in this area should shed light on development of s FGL2 as an alternative immunosuppressive agent for organ transplantation or as a biomarker for predicting disease progression, monitoring therapeutic effects, and targeting FGL2 for repression in ameliorating fulminant viral hepatitis.
文摘Objective This study aimed to elucidate the association between the level of preoperative serum fibrinogen(PSF)and the prognosis of patients with esophageal squamous cell carcinoma(ESCC).Methods From January 2010 to December 2016,all patients diagnosed with ESCC who underwent surgery in Qingdao Municipal Hospital were analyzed retrospectively.Moreover,the fibrinogen levels of all patients were assessed before surgery,and hyperfibrinogenemia was diagnosed when the fibrinogen level was≥4.0 g/L.The impact of PSF on disease-free survival(DFS)and overall survival(OS)was analyzed using the log-rank method and Cox proportional hazards regression model.P value less than 0.05 was considered statistically significant.Results A total of 336 patients were finally analyzed,and approximately 102 patients(30.36%)were diagnosed with hyperfibrinogenemia before surgery.Hyperfibrinogenemia was associated with older age(≥70 years)(P=0.012),advanced pathological T stage(P=0.003),and lymph node involvement(P=0.024).Univariate analysis showed that patients with hyperfibrinogenemia had shorter DFS(1.96 years vs.3.64 years,P=0.001)and OS(2.27 years vs.4.15 years,P<0.001)than patients without hyperfibrinogenemia.Multivariate analysis confirmed that PSF was an independent factor affecting DFS(risk ratio[RR]:1.35,95%confidence interval[CI]:1.02-1.79,P=0.038)and OS(RR:1.37,95%CI:1.03-1.83,P=0.034)in patients with ESCC.Conclusion For patients with operable ESCC,hyperfibrinogenemia had poor prognosis.Moreover,PSF is an independent prognostic factor for operable ESCC.
