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1.
Chinese Journal of Laboratory Medicine ; (12): 1070-1075, 2022.
Article in Chinese | WPRIM | ID: wpr-958622

ABSTRACT

Objective:To investigate the clinical significance of plasma thrombin-antithrombin complex (TAT) levels in patients with sepsis-induced cardiomyopathy(SIC).Methods:One hundred and seven sepsis patients who were admitted to intensive care units (ICU) of the 908th Hospital of Chinese PLA Logistical Support Force were enrolled in the study. Patients were divided into sepsis group ( n=79) and the sepsis-induced cardiomyopathy group ( n=28) according to whether the cardiac ultrasound examination in 2 hours after admission, and the differences of each indicators between the two groups were compared including acute physiological and chronic health score (APACHEⅡ), lactate, blood routine, liver and kidney function, cardiac troponin I, N-terminal?pro-brain?natriuretic?peptide (NT-pro BNP), conventional coagulation tests and molecular markers of coagulation [tissue plasminogen activator-inhibitor complex (t-PAIC), thrombomodulin (TM), TAT, plasmin-α2-plasmin inhibitor complex (PIC)].Logistical?regression?was?used?to analyze the?risk?factors?for sepsis-induced cardiomyopathy and the receiver operating characteristic (ROC) curve was to analyze their cut-off values. The effect of low-molecular-weight heparin anticoagulation therapy on sepsis patients with TAT>8.26 ng/ml was evaluated by Kaplan-Meier analysis. Results:Compared with the cardiac troponin I[0.02(0.01, 0.09) ng/ml], NT-proBNP [1 118.09 (333.25, 2687.00) pg/ml], lactate[1.35(0.90, 2.60) mmol/L], TAT[6.50(3.94, 12.14) ng/ml], PIC[1.256 (0.668, 2.045) μg/ml] and t-PAIC[10.50 (6.70, 21.30) ng/ml] in sepsis group, the cardiac troponin I [0.75(0.01, 6.02) ng/ml], NT-proBNP[12 125.14(4 185.89, 33 611.62) pg/ml], lactate[2.35(1.43, 4.34) mmol/L], TAT[19.85 (9.08, 45.78) ng/ml], PIC[2.115 (0.878, 4.114) μg/ml] and t-PAIC [22.03(15.61,33.20) ng/ml] levels in the sepsis-induced cardiomyopathy group were significantly increased ( P<0.05). Logistical regression showed that positive NT-pro BNP and elevated TAT levels were independent risk factors for sepsis-induced cardiomyopathy. ROC curve analysis showed that the area under the curve of plasma TAT level for predicting sepsis-induced cardiomyopathy was 0.78. The sensitivity and specificity at the cut-off value of plasma TAT level with 8.26 ng/ml were 0.82 and 0.63, respectively. Conclusions:The elevated TAT level was an independent risk factor for the development of sepsis-induced cardiomyopathy. Low-molecular-weight heparin anticoagulation therapy can improve the 28-day survival rate of sepsis patients with TAT>8.26 ng/ml.

2.
Chinese Critical Care Medicine ; (12): 1135-1138, 2020.
Article in Chinese | WPRIM | ID: wpr-866955

ABSTRACT

The coronavirus disease 2019 (COVID-19) has outbroken globally. As an acute infectious disease, COVID-19 has significant impacts on multiple organs and systems throughout the body. Among patients with COVID-19, especially severe and critical cases, a variety of potential risk factors for coagulation dysfunction exist. Furthermore, the coagulation dysfunction of COVID-19 patients was mainly characterized by elevated D-dimer levels. The coagulation dysfunction could directly affect the prognosis of COVID-19 patients and is a major cause of death in patients with severe COVID-19. In this article, the literatures on the basic clinical manifestations, clinical risk factor, mechanism of coagulation dysfunction and evaluation of coagulation function in COVID-19 were reviewed.

3.
Chinese Journal of Trauma ; (12): 254-258, 2019.
Article in Chinese | WPRIM | ID: wpr-745050

ABSTRACT

Objective To investigate the value of thromboelastography ( TEG) in evaluating the prognosis of polytrauma patients. Methods A retrospective case control study was conducted to analyze the clinical data of 155 polytrauma patients admitted to 94th Hospital of People's Liberation Army from September 2015 to December 2017. There were 118 males and 37 females, aged 18-88 years [(49. 0 ± 1. 3)years]. Injury severity score (ISS) was (26. 4 ± 11. 0)points. According to the prognosis of patients 90 days after injury, the patients were divided into survival group ( 143 patients ) and death group (12 patients). The ISS on admission, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), Glasgow coma score ( GCS ) , systolic blood pressure ( SBP ) , respiratory rate ( RR ) and outcome of 90 days after injury were collected. Red blood cells( RBC) , hemoglobin( Hb) , plasma prothrombin time ( PT) , activated partial thromboplastin time ( APTT) , fibrinogen ( FIB) , international normalized ratio ( INR) , thrombin time ( TT) , platelet count ( PLT) and TEG-related indicators within 2 hours after ICU admission were collected. TEG-related indicators including TCG clotting reaction time ( R ) , clot formation rate (K), clot formation kinetics (α angle), maximum amplitude (MA), coagulation index (CI), blood clotting strength (G), elasticity constant (E) and clot lysis time (CLT) were collected within 2 hours after admission to ICU. The changes of TEG-related indicators were compared between the two groups, and logistic regression analysis and receiver operating characteristic ( ROC) curve analysis were performed. Results Compared with the survival group, ISS and APACHE II scores in the death group were significantly higher, while GCS, SBP, RR, RBC and Hb were significantly lower (P<0. 05). Compared with the survival group, death group showed significantly prolonged PT [(21. 1 ± 9. 1) s vs. (16. 5 ± 4. 3)s] as well as reduced FIB [(1. 7 ± 1. 5)g/L vs. (2. 7 ± 1. 7)g/L] (P<0. 05). Compared with the survival group, the K value in the death group was significantly prolonged [5. 2(1. 8,8. 0)min vs. 2. 9(2. 1,4. 2)min] (P<0. 05). Compared with the survival group, death group showed significant decrease in G value (3762. 4 ± 3346. 7 vs. 6366. 5 ± 3886. 1), E value (75. 3 ± 67. 0 vs. 127. 3 ± 77.7),αangle[(38.4±19.7)°vs. (49.4±16.6)°],MA[(37.4±17.5)mmvs.(52.0±13.3)mm], CI [-6. 8(-9. 5, 1. 5) vs. -2. 9 ( -5. 9, -0. 7)] and CLT [39. 2 (32. 5, 46. 9) min vs. 46. 4 (32. 7, 60.8) min] (P<0. 05). There were no significant differences in APTT, TT, INR, PLT and R between the two groups (P>0. 05). Logistic regression analysis showed that MA was significantly associated with the prognosis of polytrauma patients (OR=1. 15, 95% CI 1. 04-1. 28, P<0. 05). The area under the ROC curve of MA was 0. 756 (P <0. 05). When the MA threshold was 43. 1 mm, the sensitivity, specificity, positive predictive value and negative predictive value of predicted survival were 77. 5%, 76. 9%, 76. 1% and 97. 3%, respectively. Conclusion TEG index MA can determine the prognosis of polytrauma patients, and the mortality rate is significantly increased at MA<43. 1 mm.

4.
Journal of Medical Postgraduates ; (12): 703-708, 2017.
Article in Chinese | WPRIM | ID: wpr-617608

ABSTRACT

Sepsis-induced disseminated intravascular coagulation (DIC) is a severe and relatively common disorder with high mortality in intensive care units.Sepsis at the early stage is usually manifested as hypercoagulable, while septic DIC as hypocoagulable.This article focuses on the pathophysiological mechanisms of septic DIC in the aspects up-regulation of procoagulant pathways, impairment of physiological anticoagulant mechanism, and suppression of fibrinolysis.It also gives a brief introduction to the application of thromboelastography in the diagnosis of septic DIC.

5.
Journal of Medical Postgraduates ; (12): 709-714, 2017.
Article in Chinese | WPRIM | ID: wpr-617529

ABSTRACT

Objective Secretion and aggregation dysfunction of platelets are closely related with uncontrollable septic inflammation and abnormal blood coagulation.This study was to investigate the effect of emodin on platelet aggregation (PA) and secretion in mice with late sepsis.Methods We randomly divided 111 healthy SPF male C57BL/6 mice into a sham operation (SO) group, a cecal ligation (CL) group, and an emodin (Em) group and treated those of the Em group intragastrically with emodin after cecal ligation.At 72 hours after operation, we recorded the survival rate of the mice, measured the platelet count and the levels of serum alanine aminotransferase (ALT) and creatinine (Cr), and detected the PA rate by aggregometry, the P-selectin level by flow cytometry, the serum 5-HT concentration by ELISA, and the expressions of Rab27 mRNA and protein by RT-PCR and Western blot, respectively.Results At 72 hours after cecal ligation, the survival rates in the SO, CL and Em groups were 100%, 60% and 66.7%, respectively.The platelet count was significantly decreased in the CL group as compared with that in the SO group ([461.00±64.77] vs [775.00±65.89]×109/L, P0.05).The Rab27b protein expression was markedly lower in the CL and Em groups than in the SO group (0.093±0.015 and 0.140±0.026 vs 10.380±0.036, P0.05).Conclusion Emodin can improve platelet count and aggregation, down-regulate the expression of P-selectin, protect the liver and kidney function, and reduce mortality from late sepsis.

6.
Military Medical Sciences ; (12): 626-628,651, 2015.
Article in Chinese | WPRIM | ID: wpr-602233

ABSTRACT

Objective To examine the levels of plasma tissue factor pathway inhibitor (TFPI) in patients with acute pancreatitis (AP) to assess the clinical value of diagnosis for severe acute pancreatitis ( SAP).Methods Sixty-eight patients were divided into mild acute pancreatitis (MAP)group (n=36) and SAP group (n=32), and twenty volunteers were chosen into normal group ( n=20 ) .Clinical data of these patients were collected, including APACHEⅡscore and Ranson score.Plasma levels of TFPI were measured by ELISA.Results The plasma levels of TFPI in SAP group, MAP group and control group were (4274.25 ±639.83),(3026.81 ±465.76) and (2468.73 ±262.39)pg/ml, respectively(P<0.05).There were significant positive correlations between TFPI and WBC, AST, ALT, TBIL, Cr, PT, APTT, PCT, APACHEⅡscore and Ranson score (P<0.05).The area under the curve (AUC) of TFPI for SAP was 0.902(95%CI=0.845 -0.959, P<0.05 ) .The cutoff value was 4028.83 pg/ml for plasma TFPI with a sensitivity of 87% and a specificity of 78%.Conclusion Plasma levels of TFPI in patients with SAP are significantly increased, which maybe help diagnose SAP.

7.
Chinese Journal of Trauma ; (12): 913-916, 2014.
Article in Chinese | WPRIM | ID: wpr-469554

ABSTRACT

Objective To compare the clinical effect of two hemostatic methods for patients with pelvic fracture combined with hemorrhagic shock in the early stage.Methods A retrospective analysis was done on clinical data of 90 patients with unstable pelvic fracture combined with hemorrhagic shock managed by damage control resuscitation from January 2008 to December 2012.Unstable blood pressure and abdominal distension were noted postoperatively.Forty patients in Group A received laparotomy and bilateral internal iliac artery ligation from January 2008 to January 2010.Fifty patients in Group B underwent internal iliac artery embolization from February 2010 to December 2012.Comparative measurement was made on parameters of mortality,24-hour blood transfusion volume,24-hour lactic acid value,postoperative systolic blood pressure,postoperative body temperature,and postoperative prothrombin time (PT).Results Following parameters differed significantly between Groups A and B (P < 0.05):mortality rate (53% vs 12%),24-hour blood transfusion volume[(3 865.5 ±451.3)ml vs (2 108.8 ±336.4)ml],24-hour lactic acid value[(13.0 ± 2.0)mmol/L vs (5.4 ± 1.2)mmol/L],postoperative systolic blood pressure [(80.50 ± 22.73) mmHg vs (113.23 ± 20.89) mmHg],postoperative body temperature [(32.4 ± 0.2)℃ vs (36.1 ±0.3)℃],postoperative PT [(24.5 ±3.6)s vs (18.4±2.1)s].Conclusion For pelvic fracture combined with hemorrhagic shock,if the indications of abdominal viscera rupture are unclear,the interventional embolization can gain advantage over laparotomy in improving treatment success rate and reducing mortality and complications.

8.
Chinese Journal of Emergency Medicine ; (12): 1242-1246, 2012.
Article in Chinese | WPRIM | ID: wpr-420524

ABSTRACT

Objective To examine the levels of serum tissue inhibitor of metalloproteinase in severe sepsis patients with disseminated intra-vascular coagulation (DIC) and evaluate its diagnostic value in severe sepsis with DIC.Methods Sixty patients were divided into 3 groups,namely severe sepsis group (SS group,n =28),severe sepsis with DIC group (SSD group,n =12) and normal group (n =20).Clinical data including APACHE Ⅱ score and DIC score of these patients were collected.Serum levels of TIMP-1 and TIMP-2 of these patients were measured by using ELISA.Results The patients of SS group had higher levels of TIMP-1 (723.74 ± 96.27) and lower levels of TIMP-2 (68.08 ± 14.87) than healthy control subjects (TIMP-1:574.24 ± 79.99,TIMP-2:89.99 ± 18.45) (P < 0.05).The patients of SSD group had higher levels of TIMP-1 (907.56 ± 200.20) and lower levels of TIMP-2 (44.84 ± 22.13) than patients of SS group (P < 0.05).An association was found between TIMP-1 and fibrinogen (FIB) (r =-0.392,P < 0.05),TIMP-1 and D-dimer (r =0.407,P < 0.05),TIMP-2 and PLT (r =0.484,P <0.01),TIMP-2 and PCT (r=-0.523,P<0.01),TIMP-2 and DIC score (r=-0.579,P<0.01).The areas under the curves (AUC) for TIMP-1/TIMP-2 was 0.896 (95% CI:0.843 ~ 0.950 (P < 0.05).Conclusions Serum levels of TIMP-1 in patients with severe sepsis complicated with DIC increased and TIMP-2 decreased,suggesting they were valuable in diagnosis of severe sepsis complicated with DIC.

9.
Medical Journal of Chinese People's Liberation Army ; (12)2001.
Article in Chinese | WPRIM | ID: wpr-567870

ABSTRACT

Objective To explore the role of hypoxia-inducible factor-1? (HIF-1?) in the expression of telomerase reverse transcriptase (TERT) in the pulmonary arterial smooth muscle cells (PASMCs) under anoxia.Methods HIF-1? and TERT mRNA in the PASMCs were examined by RT-PCR with the presence of HIF-1? inducers (CoCl_2,DFX),inhibitor (FAS,CBZ-LLL) and oligodeoxynucleotides,or under anoxia.HIF-1? protein in the PASMCs was determined by Western blotting.Results Expressions of HIF-1? and TERT mRNA significantly up-regulated under anoxia (0.59?0.07,0.60?0.06) compared with that in control group ( 0.11? 0.02,0.1?0.01,P0.05).Antisense oligodeoxynucleotides invalidated CoCl_2-induced increase in TERT mRNA levels (0.45?0.04) compared with CoCl_2 group (0.95?0.08,P

10.
Medical Journal of Chinese People's Liberation Army ; (12)2001.
Article in Chinese | WPRIM | ID: wpr-565918

ABSTRACT

Objective To investigate the effect of antisense telomerase reverse transcriptase (TERT) on 5-hydroxytryptamine (5-HT) induced proliferation and cell cycle of pulmonary artery smooth muscle cells (PASMCs). Methods PASMCs were cultured and divided into four groups: control group (cultured in RPMI-1640 culture medium), 5-HT group (cultured in culture medium containing 5-HT), antisense oligonucleotide (ASODN) group (cultured in culture medium containing 5-HT and ASODN TERT), and sense oligonucleotide (SODN) group (cultured in culture medium containing 5-HT and SODN TERT). The apoptosis of PASMC was observed by fluorescence microscopy with Hoechst staining. Apoptosis and cell cycle was analyzed with flow cytometry. Expression of proliferated cell nuclear antigen (PCNA) was determined by immunohistochemistry staining. Results Hoechst staining showed that apoptosis in 5-HT group (161?33) was significantly higher than that in control group (63?16, P

11.
Chinese Journal of Pathophysiology ; (12)1986.
Article in Chinese | WPRIM | ID: wpr-522275

ABSTRACT

AIM and METHODS: To explore the role of telomerase reverse transcriptase (TERT) in monocrotaline-induced pulmonary hypertension (PH), TERT was investigated by using immunohistochemistry and image analysis on the chronic PH induced by MCT in Sprague-Dawley rats. RESULTS: TERT was positive in pulmonary vascular smooth muscle cells, bronchial smooth muscle cells and chondrocytes in normal group. TERT in MCT group was more positive in pulmonary vascular smooth muscle cells and bronchial smooth muscle cells compared with normal group. CONCLUSION: Over expression of TERT in pulmonary vascular smooth muscle cells and bronchial smooth muscle cells is related to MCT-induced PH.

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