Screening for the etiology of non-cirrhotic splanchnic vein thrombosis should be taken seriously in clinical practice / 临床肝胆病杂志

Non-cirrhotic splanchnic vein thrombosis （NC-SVT） mainly includes portal vein thrombosis， superior mesenteric vein thrombosis， splenic vein thrombosis， and hepatic vein thrombosis （Budd-Chiari syndrome）， and its prevalence rate is increasing with the increase in the incidence rates of related underlying diseases. Due to the harm of NC-SVT， there have been significant improvements in the awareness and ability for diagnosis among clinicians. However， anticoagulation and intervention therapies for thrombosis are often taken seriously in treatment， while the screening for risk factors or underlying diseases leading to SVT is ignored， which may affect the treatment outcome of thrombus in some patients and delay the diagnosis and treatment of the underlying disease. This article mainly introduces the acquired， hereditary， systemic， and local underlying diseases associated with the development of NC-SVT.

Stable Expression of Coagulation Factors by RPS6 Promoter / 中国实验血液学杂志

OBJECTIVE@#To screen better promoters and provide more powerful tools for basic research and gene therapy of hemophilia.@*METHODS@#Bioinformatics methods were used to analyze the promoters expressing housekeeping genes with high abundance, so as to select potential candidate promoters. The GFP reporter gene vector was constructed, and the packaging efficiency of the novel promoter was investigated with EF1 α promoter as control, and the transcription and activities of the reporter gene were investigated too. The activity of the candidate promoter was investigated by loading F9 gene.@*RESULTS@#The most potential RPS6 promoter was obtained by screening. There was no difference in lentiviral packaging between EF1 α-LV and RPS6-LV, and their virus titer were consistent. In 293T cells, the transduction efficiency and mean fluorescence intensity of RPS6pro-LV and EF1 αpro-LV were proportional to the lentiviral dose. The transfection efficiency of both promoters in different types of cells was in the following order: 293T>HEL>MSC; Compared with EF1 αpro-LV, RPS6pro-LV could obtain a higher fluorescence intensity in MSC cells, and RPS6pro-LV was more stable in long-term cultured HEL cells infected with two lentiviruses respectively. The results of RT-qPCR, Western blot and FIX activity (FIX∶C) detection of K562 cell culture supernatant showed that FIX expression in the EF1 α-F9 and RPS6-F9 groups was higher than that in the unloaded control group, and there was no significant difference in FIX expression between the EF1 α-F9 and RPS6-F9 groups.@*CONCLUSION@#After screening and optimization, a promoter was obtained, which can be widely used for exogenous gene expression. The high stability and viability of the promoter were confirmed by long-term culture and active gene expression, which providing a powerful tool for basic research and clinical gene therapy of hemophilia.

Effect of monosialotetrahexosylganglioside sodium treatment on neurological function, inflammatory factor and blood coagulation function in patients with traumatic brain injury / 中国基层医药

Objective:To investigate the effect of monosialotetrahexosylganglioside sodium treatment on neurological function, inflammatory factor, and blood coagulation function in patients with traumatic brain injury.Methods:The clinical data of 90 patients with traumatic brain injury who received treatment in Taizhou Central Hospital from February 2018 to May 2020 were retrospectively analyzed. These patients were divided into a control group ( n = 46) and an observation group ( n = 44) according to different treatment methods. The control group was given routine symptomatic treatment and the observation group was given monosialotetrahexosylganglioside sodium treatment based on routine symptomatic treatment. Remission rate, inflammatory factor level, the National Institutes of Health Stroke Scale score, Glasgow Outcome Scale score, and coagulation function were compared between the two groups at each time point. Results:At 3 days and 2 weeks post-surgery, neuropeptide Y in the observation group was (121.13 ± 12.68) ng/L and (68.52 ± 10.21) ng/L, tumor necrosis factor α was (96.15 ± 8.16) ng/L and (46.68 ± 5.95) ng/L, interleukin-6 was (231.26 ± 9.41) ng/L and (126.74 ± 12.23) ng/L, C-reactive protein was (47.52 ± 4.32) μg/L and (18.65 ± 1.32) μg/L, the National Institutes of Health Stroke Scale score was (20.12 ± 2.22) points and (17.67 ± 1.31) points. They were significantly lower than those in the control group [neuropeptide Y: (135.69 ± 15.42) ng/L, (79.36 ± 11.15) ng/L; tumor necrosis factor-α: (108.56 ± 10.13) ng/L, (69.33 ± 6.42) ng/L; interleukin-6: (264.13 ± 10.24) ng/L and (157.89 ± 12.13) ng/L; C-reactive protein: (65.19 ± 5.17) μg/L and (24.39 ± 3.45) μg/L; the National Institutes of Health Stroke Scale score: (24.56 ± 2.54) points and (20.39 ± 2.55) points] ( t3 days post-surgery = 4.88, 6.38, 15.83, 17.55, 8.81; t2 weeks post-surgery= 4.80, 17.33, 12.12, 10.33, 6.32, all P < 0.001). At 3 days and 2 weeks post-surgery, the Glasgow Outcome Scale score in the observation group was (3.65 ± 0.35) points and (4.65 ± 0.26) points, respectively, which was significantly higher than (3.15 ± 0.10) points and (4.11 ± 0.11) points in the control group ( t = 9.30, 12.93, both P < 0.05). At 3 days and 2 weeks post-surgery, fibrinogen in the observation group was (4.52 ± 0.39) g/L and (3.12 ± 0.10) g/L, thrombin time was (18.46 ± 2.95) seconds and (21.79 ± 2.45) seconds, prothrombin time was (12.42 ± 1.33) seconds and (15.79 ± 2.36) seconds, activated partial thromboplastin time was (34.59 ± 2.64) seconds and (38.98 ± 2.78) seconds, which were significantly superior to those in the control group [fibrinogen: (5.02 ± 0.13) g/L and (4.29 ± 0.16) g/L; thrombin time: (17.36 ± 1.56) seconds and (19.63 ± 1.62) seconds; prothrombin time: (10.69 ± 1.21) seconds and (13.26 ± 1.78) seconds; activated partial thromboplastin time: (32.16 ± 2.59) seconds and (35.69 ± 2.91) seconds] ( t3 days post-surgery = 8.23, 2.22, 6.46, 4.40; t2 weeks post-surgery = 41.38, 4.95, 5.75, 5.48, all P < 0.001). At 1 and 2 weeks post-surgery, the remission rate in the observation group was significantly higher than that in the control group ( χ2 = 4.75, 4.44, both P < 0.05). Conclusion:Monosialotetrahexosylganglioside sodium treatment for a traumatic brain injury can inhibit inflammatory reactions, improve blood coagulation and protect brain tissue.

A study on gene mutation of coagulation factor Ⅺ protein secretion disorder and its mechanism / 中华检验医学杂志

Objective:To investigate the molecular pathogenesis of a newly discovered gene mutation in a family with hereditary coagulation factor Ⅺ(FⅪ) deficiency.Methods:The proband was admitted to the First Affiliated Hospital of Wenzhou Medical University in September 2021 due to "calculus of intrahepatic duct". The patient had no symptoms of spontaneous bleeding.The clinical data and blood samples of the proband and her family members (10 persons in 3 generations) were collected.The activated partial thromboplastin time (APTT) and FⅪ activity (FⅪ:C) were performed by the one-stage clotting assay. FⅪ antigen (FⅪ:Ag) were detected by enzyme linked immunosorbent assay (ELISA). Genomic DNA extracted from peripheral blood cells of subjects was used as template to analyze F11 gene mutation by DNA direct sequencing. Bioinformatics software was used to analyze the effects of mutations on protein structure and function. Wild-type and mutant FⅪ protein expression vectors were constructed and transient transfected into HEK293T cells. The total RNA was extracted from positive transfected cells and then reversely transcribed into cDNA. The mRNA expression level of F11 gene in transfected cells was detected by real-time fluorescence quantitative PCR (qRT-PCR). The content of FⅪ:Ag and the expression of FⅪ protein in transfected cell lysates and culture supernatant were detected by ELISA and western blot.Results:The APTT of the proband was significantly prolonged to 107.9s (reference range 29.0-43.0s), while FⅪ:C and FⅪ:Ag were significantly decreased to 2% (reference range 84%-122%) and 5% (reference range 76%-127%), respectively. Gene sequencing analysis indicated that the proband had c.536C>T (p.Thr161Met) heterozygous missense mutation and c.1556G>A (p.Trp501Ter) heterozygous nonsense mutation in exon 6 and 13 of the F11 gene, respectively. Bioinformatics analysis showed that the amino acids at site 161 of FⅪ protein were threonine (Thr) in the matrix composed of five different species, indicating that Thr161 site was highly conserved among homologous genes in different species. p.Thr161Met heterozygous mutation affected the stability of local intermolecular structure of FⅪ protein. In vitro expression experiments of p.Thr161Met mutation showed that FⅪ protein had a normal synthesis in the cells but secretion dysfunction.Conclusions:c.536C>T (p.Thr161Met) heterozygous missense mutation and c.1556G>A (p.Trp501Ter) heterozygous nonsense mutation were mainly responsible for the decrease of FⅪ in this family. p.Thr161Met mutation was first reported in the world and did not affect the normal synthesis of FⅪ protein, but caused secretion dysfunction.

Predictive value of coagulation indexes in maintenance peritoneal dialysis patients on the risk of all-cause death / 国际外科学杂志

Objective:To construct nomogram model based on coagulation indicators to predict the risk of all-cause death in maintenance peritoneal dialysis patients.Methods:One hundred and sixty-five patients who underwent maintenance peritoneal dialysis treatment at the Department of Nephrology, Urumqi Friendred Hospital from January 2010 to December 2018 were selected retrospectively as the research objects and were followed up once a month after the start of peritoneal dialysis treatment: inpatients were in the patient′s ward; in-home treatment were followed up by telephone. The follow-up time of all the study subjects was until death or 24 months. After the end of the follow-up period, the study subjects were divided into survival group and death group according to whether they died. General information, blood coagulation indicators, renal function indicators, blood lipids, blood potassium, blood calcium, blood phosphorus and blood glucose of the research subjects were recorded and compared the differences between the two groups of patients. The measurement data conforming to the normal distribution were expressed as mean±standarad deviation ( Mean± SD), and the student t-test was used for comparison between groups; the Chi-square test was used for comparison of enumeration data between groups. Two categories Cox regression analysis was used to determine independent risk factors for death in peritoneal dialysis patients, Nomogram prediction model was constructed, and receiver operating characteristic (ROC) was drawn to evaluate the predictive ability of the nomogram model. Results:Combined diabetes, high platelet count, short prothrombin time, short activated partial thrombin time, low international standardization ratio, high fibrinogen level, short thrombin time, high prothrombin activity, high D-dimer level and advanced age were independent risk factors for death in peritoneal dialysis patients. The Nomogram model constructed based on these risk factors had a good fitting effect, and the area under the ROC curve was 0.809 (0.792-0.825), indicating that it had strong predictive ability.Conclusions:Abnormal coagulation indicators were closely related to the risk of death in peritoneal dialysis patients. Diabetes and advanced age also had a certain predictive ability for all-cause death in peritoneal dialysis patients. Nomogram model constructed in this study could be used as a quantitative tool to predict the risk of all-cause death in peritoneal dialysis patients, help to develop individualized treatment plans for peritoneal dialysis patients and improve the prognosis of patients.

Changes in hemostasis and clinical significance of coagulation function test in patients with liver cirrhosis / 临床肝胆病杂志

The liver plays an important role in procoagulant and anticoagulant mechanisms in human body. There are complex changes in hemostasis in patients with liver cirrhosis, with the presence of interaction between the portal venous system and the peripheral system and differences in etiology, and such patients have a dual trend of hemorrhage and thrombosis. At present, there are certain limitations in coagulation function tests commonly used in clinical practice. The primary etiology and results of various coagulation tests should be considered before initiation of anticoagulant therapy for patients with liver cirrhosis, so as to make the best clinical decisions for patients.

Preparation of cryoprecipitate coagulation factor from liquid-state plasma by supercooling method / 中国输血杂志

【Objective】 To establish a novel preparation method of cryoprecipitate coagulation factor from overcooled liquid-state plasma. 【Methods】 The fresh liquid plasma was kept at -11℃ to -13℃ for a period of time. It can remain in the liquid state with some coagulation factors generated due to supercooling. Then cryoprecipitate can be obtained from the liquid plasma by siphon method. 【Results】 The average fibrinogen content yielded in cryoprecipitate, prepared from 50 samples of 16-hour-stored fresh liquid plasma, was (186.02±22.72) mg, with the average recovery rate of (37.51±7.42) %, and the average content of coagulation FⅧ was (104.66±22.88) IU, with the average recovery rate of (46.62±5.58) %. 【Conclusion】 The cryoprecipitate coagulation factors could be obtained not only from fresh frozen-thawed plasma, but also from overcooled liquid plasma which is simple and stable, also meets the requirements of relative standards.

Whole blood for blood loss: hemostatic resuscitation in damage control / Sangre total: la nueva alternativa en la resucitación hemostática

Abstract Hemorrhagic shock and its complications are a major cause of death among trauma patients. The management of hemorrhagic shock using a damage control resuscitation strategy has been shown to decrease mortality and improve patient outcomes. One of the components of damage control resuscitation is hemostatic resuscitation, which involves the replacement of lost blood volume with components such as packed red blood cells, fresh frozen plasma, cryoprecipitate, and platelets in a 1:1:1:1 ratio. However, this is a strategy that is not applicable in many parts of Latin America and other low-and-middle-income countries throughout the world, where there is a lack of well-equipped blood banks and an insufficient availability of blood products. To overcome these barriers, we propose the use of cold fresh whole blood for hemostatic resuscitation in exsanguinating patients. Over 6 years of experience in Ecuador has shown that resuscitation with cold fresh whole blood has similar outcomes and a similar safety profile compared to resuscitation with hemocomponents. Whole blood confers many advantages over component therapy including, but not limited to the transfusion of blood with a physiologic ratio of components, ease of transport and transfusion, less volume of anticoagulants and additives transfused to the patient, and exposure to fewer donors. Whole blood is a tool with reemerging potential that can be implemented in civilian trauma centers with optimal results and less technical demand.

Resumen El choque hemorrágico y sus complicaciones son la principal causa de muerte en los pacientes con trauma. La resucitación en control de daños ha demostrado una disminución en la mortalidad y mejoría en el manejo del paciente. La resucitación hemostática consiste en la recuperación del volumen con hemoderivados como glóbulos rojos, plasma, crioprecipitado y plaquetas, en proporciones de 1:1:1:1. Sin embargo, esta demanda de hemo componentes podría no aplicarse para toda Latinoamérica u otros países de medianos y bajos ingresos. Las principales barreras para la implementación de esta estrategia serían la escasa disponibilidad de bancos de sangre y de hemoderivados insuficientes para contar con un protocolo de transfusión masiva. Una propuesta para superar estas barreras es el uso de sangre total fresca fría para la resucitación hemostática de los pacientes exsanguinados. Ecuador ha sido pionero en la implementación de esta estrategia con una experiencia ya de seis años, en que han demostrado que la sangre total tiene ventajas sobre la terapia de hemo componentes incluyendo, pero no limitando, la trasfusión de sangre con una razón fisiológica de componentes, fácil transporte y transfusión, menor volumen de anticoagulantes y aditivos trasfundidos al paciente, y menor exposición a donantes. La sangre total es una herramienta con un potencial reemergente que puede ser implementado en centros de trauma civil con óptimos resultados y menor demanda técnica.

Clinical features of liver function and coagulation function in patients with Alongshan virus infection / 临床肝胆病杂志

ObjectiveTo investigate the clinical features of liver function and coagulation function in patients with Alongshan virus (ALSV) infection. MethodsClinical data were collected from 27 patients with ALSV infection who were admitted to Inner Mongolia General Forestry Hospital from May 2018 to September 2019, among whom there were 18 male patients and 9 female patients. Related data were extracted, and a database of relevant case reports was established. The descriptive epidemiological method was used to analyze the clinical features of liver function and coagulation markers, and the features of liver injury caused by ALSV infection were analyzed. ResultsFor the 27 patients, the abnormal rates of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GGT), cholinesterase, and total bile acid were 25.9%, 33.3%, 25.9%, 40.7%, 8%, and 8%, respectively; among the 27 patients, 4 (14.8%) had an ALT level of ＞2×upper limit of normal (ULN), 3 (11.1%) had an AST level of ＞2×ULN, 1 (3.7%) had an ALP level of ＞2×ULN, and 5 (18.5%) had a GGT level of ＞2×ULN. Among the 27 patients, 25 (17 male patients and 8 female patients) had the results of bilirubin test, among whom 1 had a reduction in total bilirubin (TBil) (3.30 μmol/L) and 3 had an increase in TBil (23.7 μmol/L, 26.2 μmol/L, and 32 μmol/L, respectively). The abnormal rates of the coagulation markers international normalized ratio, activated partial thromboplastin time, and fibrinogen were 3.7%, 11.1%, and 22.2%, respectively. ConclusionThere is a certain degree of liver injury in patients with ALSV infection, generally with mild symptoms.

Evaluation of coagulation factor activity and sterility of thawed fresh frozen plasma during storage up to 5 days at 4°C

@#Introduction: Fresh frozen plasma (FFP) is a blood component containing functional quantities of all coagulation factors stored at -18°C or below. FFP has to be thawed and transfused as soon as possible to prevent the loss of certain coagulation factor activities and to minimise microbial contamination. Materials and Methods: Thirty units of FFP kept at -20°C were thawed using a 37°C water bath and immediately sampled for baseline Factor II (FII), Factor VIII (FVIII) and fibrinogen activity levels and sterility testing. Each unit was then divided into two smaller bags (i.e. Bag I and Bag II) and kept at 4°C. At 6 hours and Day 3, representative samples were taken from Bag I for coagulation factor activity assays, while at Day 5 representative samples were taken from Bag II for coagulation factor activity assays and sterility testing. Results: FII activities at the four time points were 73.43%, 73.73%, 71% and 69.8%, respectively, while FVIII activities were 177.63%, 144.37%, 80.8% and 70.97%, respectively. Fibrinogen levels at the four time points were 3.24 g/L, 3.24 g/L, 3.21 g/L and 3.20 g/L, respectively. All samples were free from microbial contamination even at Day 5. Conclusion: The mean reduction in FII and fibrinogen activities on Day 5 was 5% and 1%, respectively. However, FVIII activity declined significantly by approximately 60% at Day 5. Despite these reductions, thawed plasma stored for up to 5 days at 4°C is still suitable for use as the coagulation factor activity levels still exceed the minimum release criteria recommended in quality assurance regulations.

Human acute Chagas disease: changes in factor VII, activated protein C and hepatic enzymes from patients of oral outbreaks in Pará State (Brazilian Amazon)

Oral transmission of Chagas disease has been increasing in Latin American countries. The present study aimed to investigate changes in hepatic function, coagulation factor levels and parasite load in human acute Chagas disease (ACD) secondary to oral Trypanosoma cruzi transmission. Clinical and epidemiological findings of 102 infected individuals attended in the State of Pará from October 2013 to February 2016 were included. The most common symptoms were fever (98%), asthenia (83.3%), face and limb edema (80.4%), headache (74.5%) and myalgia (72.5%). The hepatic enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST) of 30 ACD patients were higher compared with controls, and this increase was independent of the treatment with benznidazole. Moreover, ACD individuals had higher plasma levels of activated protein C and lower levels of factor VII of the coagulation cascade. Patients with the highest parasite load had also the most increased transaminase levels. Also, ALT and AST were associated moderately (r = 0.429) and strongly (r = 0.595) with parasite load respectively. In conclusion, the present study raises the possibility that a disturbance in coagulation and hepatic function may be linked to human ACD.

Role of crotoxin in coagulation: novel insights into anticoagulant mechanisms and impairment of inflammation-induced coagulation

Snake venom phospholipases A2 (svPLA2) are biologically active toxins, capable of triggering and modulating a wide range of biological functions. Among the svPLA2s, crotoxin (CTX) has been in the spotlight of bioprospecting research due to its role in modulating immune response and hemostasis. In the present study, novel anticoagulant mechanisms of CTX, and the modulation of inflammation-induced coagulation were investigated. Methods: CTX anticoagulant activity was evaluated using platelet poor plasma (PPP) and whole blood (WB), and also using isolated coagulation factors and complexes. The toxin modulation of procoagulant and pro-inflammatory effects was evaluated using the expression of tissue factor (TF) and cytokines in lipopolysaccharide (LPS)-treated peripheral blood mononuclear cells (PBMC) and in WB. Results: The results showed that CTX impaired clot formation in both PPP and WB, and was responsible for the inhibition of both intrinsic (TF/factor VIIa) and extrinsic (factor IXa/factor VIIIa) tenase complexes, but not for factor Xa and thrombin alone. In addition, the PLA2 mitigated the prothrombinase complex by modulating the coagulation phospholipid role in the complex. In regards to the inflammation-coagulation cross talk, the toxin was capable of reducing the production of the pro-inflammatory cytokines IL-1β, IL-6 and TNF-α, and was followed by decreased levels of TF and procoagulant activity from LPS-treated PBMC either isolated or in WB. Conclusion: The results obtained in the present study recognize the toxin as a novel medicinal candidate to be applied in inflammatory diseases with coagulation disorders.(AU)

Effect of cinobufagin capsule on coagulation state, therapeutic effect and quality of life in patients with advanced lung cancer / 中国基层医药

Objective To explore the effects of cinobufagin capsule on coagulation status,therapeutic effect and quality of life of patients with advanced lung cancer.Methods A total of 64 patients with advanced lung cancer admitted to the Second People＇s Hospital of Jinzhong from February 2017 to January 2018 were selected,and they were divided into control group and observation group by random number table method,with 32 cases in each group.The control group was treated with chemotherapy, and the observation group was treated with cinobufagin capsules combined with chemotherapy.Blood coagulation status,quality of life score,pain numerical rating scale ( NRS) and functional status score( KPS) were observed before and after treatment in the two groups.The clinical efficacy was compared between the two groups. Results Before treatment, there were no statistically significant differences in plasma fibrinogen(FIB),platelet(PLT),D-dimer,quality of life score,NRS score and KPS score between the two groups(all P>0.05).After treatment,the FIB,PLI and D-dimers in the observation group were (3.6 ± 0.9)g/L, (248.3 ± 11.3) ×109/L,(19.8 ± 1.2) mg/L respectively,which were significantly lower than those in the control group [(4.5 ± 0.6)g/L,(398.2 ± 16.2) ×109/L,(40.2 ± 0.6) mg/L] (t=11.642,21.045,18.249,all P＜0.05).The total effective rate of the observation group was 90.6%(29/32),which was significantly higher than 68.8%(22/32) of the control group ( χ2 =6.903,P ＜0.05). The quality of life scores of the two groups were improved,and the life scores of the observation group were significantly higher than those of the control group( t=11.642,21.045,18.249,17.218,all P＜0.05).The NRS score of the observation group (3.62 ± 1.53) points was significantly lower than that of the control group[(5.01 ± 2.34)points],and the KPS score of the observation group [(78.25 ± 3.81) points] was significantly higher than that of the control group [( 72. 34 ± 4. 12 ) points], the differences were statistically significant (t =16.082,15.082,all P ＜0.05). Conclusion Treatment of advanced lung cancer with cinobufagin capsule combined with chemotherapy can significantly improve the coagulation state, treatment effect and quality of life of patients.

Effect of cinobufagin capsule on coagulation state, therapeutic effect and quality of life in patients with advanced lung cancer / 中国基层医药

Objective@#To explore the effects of cinobufagin capsule on coagulation status, therapeutic effect and quality of life of patients with advanced lung cancer.@*Methods@#A total of 64 patients with advanced lung cancer admitted to the Second People's Hospital of Jinzhong from February 2017 to January 2018 were selected, and they were divided into control group and observation group by random number table method, with 32 cases in each group.The control group was treated with chemotherapy, and the observation group was treated with cinobufagin capsules combined with chemotherapy.Blood coagulation status, quality of life score, pain numerical rating scale (NRS) and functional status score(KPS) were observed before and after treatment in the two groups.The clinical efficacy was compared between the two groups.@*Results@#Before treatment, there were no statistically significant differences in plasma fibrinogen(FIB), platelet(PLT), D-dimer, quality of life score, NRS score and KPS score between the two groups(all P>0.05). After treatment, the FIB, PLI and D-dimers in the observation group were (3.6±0.9)g/L, (248.3±11.3)×109/L, (19.8±1.2)mg/L respectively, which were significantly lower than those in the control group [(4.5±0.6)g/L, (398.2±16.2)×109/L, (40.2±0.6)mg/L] (t=11.642, 21.045, 18.249, all P<0.05). The total effective rate of the observation group was 90.6%(29/32), which was significantly higher than 68.8%(22/32) of the control group(χ2=6.903, P<0.05). The quality of life scores of the two groups were improved, and the life scores of the observation group were significantly higher than those of the control group(t=11.642, 21.045, 18.249, 17.218, all P<0.05). The NRS score of the observation group (3.62±1.53)points was significantly lower than that of the control group[(5.01±2.34)points], and the KPS score of the observation group[(78.25±3.81)points] was significantly higher than that of the control group[(72.34±4.12)points], the differences were statistically significant (t=16.082, 15.082, all P<0.05).@*Conclusion@#Treatment of advanced lung cancer with cinobufagin capsule combined with chemotherapy can significantly improve the coagulation state, treatment effect and quality of life of patients.

Hemofilia: abordaje diagnóstico y terapéutico. Revisión bibliográfica / Hemophilia: Diagnostic and Therapeutic Approach. A Literature review / Hemofilia: aproximação diagnóstica e terapêutica. Revisão bibliográfica

Resumen Antecedentes: La hemofilia es una enfermedad de origen genético, recesiva y ligada al cromosoma X; su principal manifestación clínica es la hemorragia, cuyo grado depende del nivel del factor VIII o IX que se halla en el plasma, usualmente secundaria a traumas en sitios de localización profunda, como articulaciones, músculos y sistema nervioso central. Objetivo: El objetivo es presentar una revisión bibliográfica clara y práctica de la hemofilia, donde se abordan aspectos generales de la fisiopatología, el diagnóstico y el manejo, al igual que las nuevas alternativas terapéuticas en desarrollo para su tratamiento. Metodología: Se llevó a cabo una búsqueda en las bases de datos PubMed, ScienceDirect y Scielo, a partir de las palabras clave en español e inglés. Se seleccionaron 32 artículos que fueron la base para la construcción de este manuscrito. Resultados: Se construyó una revisión bibliográfica que incluye conceptos básicos y prácticos para el enfoque y el abordaje de la hemofilia. Conclusión: La hemofilia es una entidad potencialmente mortal, que afecta la calidad de vida de los pacientes y de aquellos que lo rodean; es un reto hacer un enfoque adecuado para el diagnóstico y el tratamiento.

Abstract Background: Hemophilia is a genetic, recessive disorder linked to the X chromosome. Its main clinical symptom is he morrhage, whose degree depends on the level of factor VIII or IX found in plasma, usually following traumas in deep sites, such as joints, muscles and central nervous system. Objecti ve: The objective is to present a clear and practical literature review of hemophilia, with general aspects of its pathophysio logy, diagnosis and treatment, as well as the new therapeutic alternatives being developed for its treatment. Methodology: the PubMed, ScienceDirect and Scielo databases were chec ked, using keywords in Spanish and English. We selected 32 articles, which were the basis for constructing this text. Re sults: a bibliographic review including basic and practical concepts for the approach and treatment of hemophilia was constructed. Conclusion: hemophilia is a potentially deadly disorder, affecting the quality of life of patients and those around them as finding a proper approach for its diagnosis and treatment is challenging.

Resumo Antecedentes: a hemofilia é uma doença de origem genética, re cessiva e ligada ao cromossoma X. A sua principal manifestação clínica é a hemorragia, cujo grau depende do nível do fator VIII ou IX achado no plasma, usualmente secundária a traumas em lugares profundos, como articulações, músculos e o sistema ner voso central. Objetivo: apresentar uma revisão bibliográfica clara e prática da hemofilia, com aspetos gerais da fisiopatologia, do diagnóstico e da gestão, também de novas alternativas de terapia em desenvolvimento para o tratamento. Metodologia: pesquisou-se nas bases de dados PubMed, ScienceDirect e Scielo, com pala vras chaves no espanhol e no inglês. Selecionaram-se 32 artigos, que foram a base para construir este texto. Resultados: construiu-se uma revisão bibliográfica incluindo conceitos básicos e prá ticos para o enfoque e o tratamento da hemofilia. Conclusão: a hemofilia é uma entidade potencialmente mortal, afetando a qua lidade de vida dos pacientes e dos que estão ao seu redor, é um desafio fazer uma aproximação apropriada para o diagnóstico e para o tratamento.

Calidad de vida: un aspecto olvidado en el paciente con hemofilia / Quality of life: a forgotten aspect in the patient with hemophilia

La hemofilia es una patología derivada de la deficiencia heredada de factores de la coagulación, comúnmente ligada al cromosoma X que presenta diferentes tipos de hemorragias. Clínicamente la hemofilia se clasifica según la deficiencia del factor de coagulación específico y su cuadro clínico se compone de episodios hemorrágicos y de las complicaciones de los mismos. A pesar de los grandes avances en la medicina, la hemofilia persiste como una enfermedad crónica asociada a importantes secuelas que generan un impacto sobre la calidad de vida. A nivel mundial, 1/10.000 hombres está afectado por esta enfermedad, lo que a nivel local se traduce como 3,8 a 4,3 afectados por cada 100.000 habitantes. La calidad de vida es un importante concepto que se debe tener en cuenta en el abordaje integral de pacientes que Hemofilia ya que los factores biológicos relacionados con esta patología tienen gran impacto en el deterioro físico, social y psicológico de los pacientes afectados y, obviar su valoración significa perpetuar el deterioro generado por la enfermedad. La medición de la calidad de vida de estos pacientes debe ser de carácter rutinario en la práctica clínica mediante el uso de herramientas internacionalmente validadas..(AU)

Hemophilia is a pathology derived from the deficiency inherited from coagulation factors, commonly linked to the X chromosome that presents different types of hemorrhages. Clinically, hemophilia is classified according to the deficiency of the specific coagulation factor and its clinical picture is composed of hemorrhagic episodes and their complications. Despite the great advances in medicine, hemophilia persists as a chronic disease associated with important ramifications that have an impact on the quality of life. Worldwide, 1 / 10,000 men are affected by this disease, which in our country translates as 3.8 to 4.3 affected per 100,000 inhabitants. Quality of life is an important concept that should be taken into account in the overall approach of patients with hemophilia since the biological factors related to this pathology have a great impact on the physical, social and psychological deterioration of the affected and, to obviate its assessment means perpetuating the deterioration caused by the disease. The measurement of the quality of life of these patients should be routine in clinical practice through the use of internationally validated tools..(AU)

Influence of chronic caregiving stress on chronic diseases risk to family caregivers of patients with dementia: A research progression / 中华老年医学杂志

Dementia care is a chronic stressor severely influencing on physical and mental health and social life of family caregivers.In the research field of dementia care,the studies are inadequate regarding to the influence of caregiving stress on physical and mental health,especially on the risk of suffering from common chronic disease of family caregivers.So far,the studies are mainly based on hypotheses associated with chronic stress-induced three perspectives,i.e.,excessive activation of sympathetic nervous system,endothelial injury,and excessive activation of pro-inflammatory and procoagulant factors.This paper summarizes the research progress from these three perspectives.

Procalcitonin combined with coagulation factors in prognosis of cirrhotic patients complicated with spontaneous bacterial peritonitis / 中华临床感染病杂志

Objective To examine the short-term prognostic value of procalcitonin ( PCT ) combined with coagulation factors for cirrhotic patients complicated with spontaneous bacterial peritonitis (SBP).Methods Clinical data of 128 cirrhotic patients complicated with SBP admitted in Jinhua Central Hospital from June 2014 to October 2017 were retrospectively analyzed .In 3 months after admission , 83 patients survived ( survival group ) and 45 patients died ( fatal group ) .The factors related to prognosis were analyzed with Logistic regression and the prediction model was constructed with the weights derived from regression coefficients.The ROC curve and the area under the curve (AUC) of combination of PCT with coagulation factors were used to predict the survival of patients .Results Univariate analysis indicated that the level of PCT , total bilirubin ( TBil ) , serum creatinine ( Scr ) , prothrombin time ( PT ) , prothrombin activity ( PTA ) , blood coagulation factor Ⅱ, Ⅴ, Ⅶ, Ⅸ, Ⅹ, Ⅺ and Ⅻ were factors affecting the prognosis of cirrhotic patients complicated with SBP (P<0.01).Multivariate analysis showed that PCT , blood coagulation factors Ⅴ and Ⅸ were independent factors of short-term prognosis of cirrhotic patients complicated with SBP.The constructed predictive model was Logit (P) =1.200+0.099 ×PCT-0.026 × clotting factor Ⅴ-0.038 ×clotting factor Ⅸ.The sensitivity and specificity of the model were 0.822 and 0.675, respectively, and the AUC was 0.829.Compared with the classic MELD score , the difference was not statistically significant (P>0.05).Conclusions The predictive model based on PCT and coagulation factors Ⅴand Ⅸcan effectively predict the short-term survival of cirrhotic patients complicated with SBP . The overall prognostic ability is not different from MELD score , but the model is more simple and easier to apply.

The 2nd Meeting of National Control Laboratories for Vaccines and Biologicals in the Western Pacific

The Second Meeting of the National Control Laboratories for Vaccines and Biologicals in the Western Pacific, was jointly organized by the National Institute of Food and Drug Safety Evaluation of the Ministry of Food and Drug Safety in the Republic of Korea, and by the World Health Organization Regional Office for the Western Pacific. In the National Lot Release Systems session countries including Canada, China, Japan, Malaysia, Vietnam, and the Republic of Korea, all shared information on their current Lot Release Systems, including current practices and developments in risk-based official lot release of vaccines. In the session on Quality Control of Blood Products, experts from the National Institute for Biological Standards and Control shared quality control and research results for; blood coagulation factor VIII products, and the measurement of procoagulant activity in immunoglobulin products. Representatives from Japan proposed a regional collaborative study to test aggregated immunoglobulin free from complement activity. A cell-based Japanese encephalitis vaccine potency assay was proposed by representatives from Korea and they also called for voluntary participation of other National Control Laboratories in a collaborative study, on the first Korean Gloydius anti-venom standard. Participants agreed in general to continue communicating, and coordinate presentation of the study results.