Evaluation of descriptive performances of platelet indices, neutrophil/lymphocyte ratio, and platelet/lymphocyte ratio in aortic dissections

SUMMARY OBJECTIVE: Mechanical damage resulting from aortic dissection creates a thrombus in the false lumen, in which platelets are involved. Platelet index is useful for the function and activation of platelets. The aim of this study was to show the clinical relevance of the platelet index of aortic dissection. METHODS: A total of 88 patients diagnosed with aortic dissection were included in this retrospective study. Demographic data and hemogram and biochemistry results of the patients were determined. Patients were divided into two groups: deceased and surviving patients. The data obtained were compared with 30-day mortality. The primary outcome was the relationship of platelet index with mortality. RESULTS: A total of 88 patients, 22 of whom were female (25.0%), diagnosed with aortic dissection, were included in the study. It was determined that 27 (30.7%) of the patients were mortal. The mean age of the entire patient group was 58±13 years. According to the DeBakey classification of aortic dissection of the patients, the percentages of the 1-2-3 type were determined as 61.4, 8.0, and 30.7%, respectively. Platelet index was not found to be directly related to mortality. Increase in age, decrease in bicarbonate value, and presence of diabetes mellitus were associated with mortality. CONCLUSION: Although there were no significant changes in platelet index in aortic dissection, neutrophil/lymphocyte ratio and platelet/lymphocyte ratio were found to be high in line with the literature. In particular, the presence of advanced age diabetes mellitus and decrease in bicarbonate are associated with mortality.

Effect of proprotein convertase subtilisin/kexin type 9 on platelet activation associated with sepsis / 中华危重病急救医学

Objective:To investigate the effect of proprotein convertase subtilisin/kexin type 9 (PCSK9) on platelet activation in sepsis.Methods:① Clinical trial: a prospective study was conducted. Patients with sepsis and septic shock aged ≥ 18 years old who met the diagnostic criteria of Sepsis-3 admitted to the department of intensive care medicine of the Affiliated Hospital of Binzhou Medical College from January to October in 2021 were selected as subjects. Healthy subjects in the same period were taken as healthy control group. Platelet count (PLT) in the first routine blood test after admission was recorded. Venous blood was taken 1 day after diagnosis, and serum PCSK9 level was determined by enzyme-linked immunosorbent assay (ELISA). The differences of PCSK9 level and PLT between the two groups were compared, and subgroup analysis was conducted based on PLT for patients with sepsis. The correlation between PCSK9 level and PLT in septic patients was analyzed by Pearson correlation method. ② Animal experiment: 80 male C57BL/6 mice were randomly divided into control group, sepsis model group [lipopolysaccharide (LPS) group], PCSK9 inhibitor pretreatment group (PCSK9 inhibitor+LPS group) and PCSK9 inhibitor control group (PCSK9 inhibitor group), with 20 mice in each group. The mouse model of sepsis was reproduced by intraperitoneal injection of LPS 12 mg/kg, and the control group and PCSK9 inhibitor group were intraperitoneally injected with the same amount of sterile normal saline. PCSK9 inhibitor+LPS group and PCSK9 inhibitor group were pretreated with PCSK9 inhibitor 5 mg/kg intraperitoneal injection for 7 days before injection of LPS or normal saline, respectively, and the control group and LPS group were injected with an equal amount of sterile normal saline. The lung tissues were taken for pathological and immunohistochemical observation 24 hours after modeling. Blood was taken from the heart for determining PLT. Platelet activation was detected by flow cytometry. The expression level of platelet-activation marker CD40L was detected by Western blotting.Results:① Clinical trial: there were 57 cases in the sepsis group and 27 cases in the healthy control group. Serum PCSK9 level in the sepsis group was significantly higher than that in the healthy control group (μg/L: 232.25±72.21 vs. 191.72±54.92, P < 0.05), and PLT was significantly lower than that in the healthy control group [×10 9/L: 146.00 (75.50, 204.50) vs. 224.00 (194.00, 247.00), P < 0.01]. Subgroup analysis showed that the serum PCSK9 level in the thrombocytopenia patients ( n = 20) was significantly higher than that in the non-thrombocytopenia patients ( n = 37; μg/L: 264.04±60.40 vs. 215.06±72.95, P < 0.01). Correlation analysis showed a significant negative correlation between serum PCSK9 levels and PLT in septic patients ( r = -0.340, P = 0.010). ② Animal experiment: there were no significant pathological changes in lung tissue in the control group and PCSK9 inhibitor group under light microscope, and no significant differences in PLT, platelet activation and plasma CD40L protein expression was found between the two groups. In the LPS group, a large number of inflammatory cells were infiltrated in the pulmonary interstitium, the alveolar structure was damaged obviously, the alveolar septum was widened, the alveolar cavity was extensively bleeding, the capillary dilatation with bleeding and platelet aggregation were found, the PLT was significantly decreased, the platelet activation and the expression level of CD40L protein in plasma were significantly increased. The infiltration of inflammatory cells in lung tissue of mice in the PCSK9 inhibitor+LPS group was reduced to a certain extent, the thickening of alveolar septa was reduced, the platelet aggregation in lung tissue was decreased as compared with the LPS group, the PLT was significantly increased (×10 9/L: 515.83±46.60 vs. 324.83±46.31, P < 0.05), the platelet activation and the expression level of CD40L protein in plasma were significantly decreased [positive expression rate of platelet activation dependent granule surface facial mask protein CD62P: (12.15±1.39)% vs. (18.33±2.74)%, CD40L protein (CD40L/β-actin): 0.77±0.08 vs. 1.18±0.10, both P < 0.05]. Conclusion:PCSK9 level has a certain effect on promoting platelet activation in sepsis, and inhibition of PCSK9 level may have potential research value in improving adverse outcomes caused by sepsis thrombocytopenia.

Effects and mechanism of Danshen decoction on physiological characteristics and function of platelet in hyperli-pidemia model rats / 中国药房

OBJECTIVE To investigate the effects and mechanism of Danshen decoction influencing platelet physiological characteristics and function in hyperlipidemia model rats based on platelet membrane glycoprotein 4 （CD36）/phosphatidylinositol 3- kinase （PI3K）/protein kinase B （Akt） signaling pathway. METHODS The hyperlipidemia model rats were induced by feeding high- fat diet， and then randomly divided into model group， simvastatin group （0.004 g/kg）， Danshen decoction high-dose and low-dose groups （3.6， 0.9 g/kg）， and blank group （fed with basic feed）， with 10 rats in each group. Rats in each administration group were intragastrically administered with corresponding drugs every day， and the other groups were intragastrically administered with equal volume of normal saline for 4 weeks. After the last administration， the contents of blood lipid biochemical indexes [total cholesterol （TC）， triglyceride （TG）， high-density lipoprotein cholesterol （HDL-C）， low-density lipoprotein cholesterol （LDL-C）]， whole blood viscosity， plasma viscosity and fibrinogen （FIB）content in plasma， platelet-related parameters [platelet count （PLT）， platelet distribution width （PDW） and mean plateletvolume （MPV）] were detected. The levels of plateletphysiological characteristics and function-related factors [von Willebrand factor （vWF）， fibronectin （Fn）， phospholipase A2（PLA2）， thromboxane B2 （TXB2）， 6-keto-prostaglandin F1α （6-keto-PGF1α）， thromboxane A2 （TXA2）， prostaglandin I2 （PGI2）， cyclic adenosine monophosphate （cAMP）， cyclic guanosine monophosphate （cGMP）， β-thromboglobulin （β-TG）]， platelet aggregation rate （maximum aggregation rate， 60 s aggregation rate， 180 s aggregation rate） and fibrinolytic system-related factors [tissue plasminogen activator （t-PA）， plasminogen activator inhibitor 1 （PAI-1）] and the expressions of CD36/PI3K/Akt signaling pathway-related proteins [CD36， focal adhesion kinase （FAK）， phosphatidylinositol 4-phosphate 5-kinase （PIP5K）， PI3K， phosphorylated Akt （p-Akt）， p-Akt1/2/3] in platelet were all determined. RESULTS Compared with blank group， the contents of TC， TG and LDL-C in plasma， whole blood viscosity， plasma viscosity， the plasma levels of FIB， PLT， MPV， vWF， Fn， PLA2， TXB2， TXA2， cGMP and β-TG， maximum platelet aggregation rate， 60 s aggregation rate， the expressions of PAI-1 in plasma， protein expressions of CD36， FAK， PIP5K， PI3K， p-Akt and p-Akt1/2/3 were significantly increased in the model group （P＜0.05）. The content of HDL-C and the levels of 6-keto-PGF1α， PGI2 and t-PA were significantly decreased （P＜0.05）. After the intervention of Danshen decoction， most of the above indexes were significantly reversed （P＜0.05）. CONCLUSIONS Danshen decoction can improve the physiological characteristics and function of platelets in hyperlipidemia model rats， and its mechanism may be related to the down-regulation of CD36/PI3K/Akt signaling pathway activity and the reduction of platelet activation.

Evaluation of platelet indices and pro-inflammatory cytokines in type 2 diabetic patients with retinopathy

SUMMARY OBJECTIVE: The aim of this study was to investigate whether platelet parameters and pro-inflammatory cytokines associated with platelet activation could be surrogate markers of the diabetic retinopathy stages in type 2 diabetic patients. METHODS: This prospective case-control study included 108 type 2 diabetes mellitus patients and 48 healthy controls. After fundoscopic examination, patients were divided into three groups: no retinopathy, nonproliferative diabetic retinopathy, or proliferative retinopathy. Platelet selectin, interleukin-1alpha, and interleukin-6 values were measured by the enzyme-linked immunosorbent assay method. Homeostatic Model Assessment for Insulin Resistance formula was used to assess insulin resistance in patients. RESULTS: Mean platelet volume was lower and interleukin-1alpha was higher in the patients compared to the healthy controls (p=0.046 and p<0.001, respectively). In addition, a positive correlation between the platelet distribution width and HbA1C levels was observed in the patients (r=0.334, p<0.001). CONCLUSION: In the studies evaluating the utility of platelet indices and the associated cytokines in diabetic retinopathy, there is a need for the standardization of the measurements. All medications that can affect platelet activation should be taken into consideration.

Immature Platelet Fraction and Thrombin Generation: Preeclampsia Biomarkers / Fração de plaquetas imaturas e geração de trombina: Biomarcadores da pré-eclâmpsia

Abstract Preeclampsia, a human pregnancy syndrome, is characterized by elevated blood pressure and proteinuria after the 20th week of gestation. Its etiology remains unknown, and its pathophysiological mechanisms are related to placental hypoperfusion, endothelial dysfunction, inflammation, and coagulation cascade activation. Recently, the role of the complement system has been considered. This syndrome is one of the main causes of maternal and fetal mortality and morbidity. This article discusses the hypothesis of preeclampsia being triggered by the occurrence of inadequate implantation of the syncytiotrophoblast, associated with bleeding during the first stage of pregnancy and with augmented thrombin generation. Thrombin activates platelets, increasing the release of antiangiogenic factors and activating the complement system, inducing the membrane attack complex (C5b9). Immature platelet fraction and thrombin generation may be possible blood biomarkers to help the early diagnosis of preeclampsia.

Resumo A pré-eclâmpsia, uma síndrome da gestação humana, é caracterizada por elevação da pressão arterial e proteinúria patológica após a 20ª semana de gestação. Sua etiologia permanece desconhecida, e seus mecanismos fisiopatológicos estão relacionados à hipoperfusão placentária, disfunção endotelial, inflamação, e ativação da cascata de coagulação. Recentemente, o papel do sistema do complemento foi considerado. Essa síndrome é uma das principais causas de morbidade e mortalidade materna e fetal. Este artigo discute a hipótese de a pré-eclâmpsia ser desencadeada pela ocorrência da implantação inadequada do sinciciotrofoblasto, associada ao sangramento durante o primeiro trimestre da gravidez com aumento da geração de trombina. A trombina ativa plaquetas, aumentando a liberação de fatores antiangiogênicos na circulação e ativando o sistema do complemento, especialmente o complexo de ataque de membrana (C5b9). Portanto, a fração de plaquetas imaturas e a geração de trombina podem ser possíveis biomarcadores sanguíneos para auxílio no diagnóstico precoce da pré-eclâmpsia.

Dialysis-related thrombocytopenia: a case report / Plaquetopenia relacionada à hemodiálise: relato de caso

Abstract Thrombocytopenia is frequently observed in hemodialysis patients, and its correct investigation and control remain a challenge. It is estimated that during the hemodialysis session there is a drop of up to 15% in the platelet count, with recovery after the end of treatment. This reduction in platelets is due to platelet adhesion and complement activation, regardless of the membrane material. Several studies with platelet surface markers demonstrate increased platelet activation and aggregation secondary to exposure to cardiopulmonary bypass. This case report describes a patient on hemodialysis who developed severe thrombocytopenia during hospitalization. Investigation and exclusion of the most common causes were carried out: heparin-related thrombocytopenia, adverse drug reaction, hypersplenism, and hematological diseases. Afterwards, the possibility of hemodialysis-related thrombocytopenia was raised, since the fall was accentuated during the sessions with partial recovery after the dialyzer change. Attention to the sterilization method and dialyzer reuse must be considered for correction. In the current case, reusing the dialyzer minimized the drop in platelet counts associated with hemodialysis.

Resumo Plaquetopenia é frequentemente observada em pacientes em hemodiálise, e sua correta investigação e controle permanecem um desafio. Estima-se que, durante a sessão de hemodiálise, ocorra queda de até 15% da contagem de plaquetas, com recuperação após o término do tratamento. Essa queda de plaquetas é decorrente de adesão plaquetária e ativação do complemento, independentemente do material da membrana. Vários estudos com marcadores de superfície plaquetária demonstram aumento da ativação e agregação plaquetária secundários à exposição à circulação extracorpórea. Este relato de caso mostra um paciente dialítico que evoluiu com plaquetopenia severa durante internação. Realizada investigação e exclusão de causas mais comuns: plaquetopenia relacionada à heparina, reação adversa a medicamentos, hiperesplenismo e doenças hematológicas, foi então aventada a possibilidade de plaquetopenia relacionada à hemodiálise após observação de que a queda se acentuava durante as sessões de hemodiálise com recuperação parcial após. Mudança do dialisador, atenção ao método de esterilização e realização do reuso devem ser consideradas para correção. No presente caso, a utilização do reuso minimizou a plaquetopenia associada a hemodiálise.

Ligustrazine suppresses platelet aggregation through inhibiting the activities of calcium sensors

Abstract Ligustrazine is widely used for the treatment of cardiovascular diseases in traditional Chinese medication. It has been reported that Ligustrazine decreases the concentration of intracellular calcium ions (Ca2+); however, the underlying mechanism remains unknown. In the present study, the effect of Ligustrazine on adenosine diphosphate (ADP)-induced platelet aggregation was evaluated using a turbidimetric approach. The changes in concentration of intracellular Ca2+ stimulated by ADP was measured using fluo-4, a fluorescent Ca2+ indicator dye. The mRNA expression of stromal interaction molecule l (STIM1) and Orai1, calcium sensor, was determined using real-time PCR. In addition, the protein expression of STIM1, Orai1, and serum/glucocorticoid-regulated protein kinase 1 (SGK1) was determined using Western blot analysis. The data demonstrated that Ligustrazine significantly suppressed platelet aggregation in a dose-dependent manner and reduced the concentration of intracellular Ca2+ triggered by ADP. Our data showed that Ligustrazine treatment inhibited the expression of STIM1 and Orai1 induced by ADP at both mRNA and protein levels, and suppressed the protein expression of SGK1. Taken together, our data indicated that Ligustrazine suppressed platelet aggregation by partly inhibiting the activities of calcium sensors, thereby suggesting that Ligustrazine may be a promising candidate for the treatment of platelet aggregation.

Effects of plasma lipopolysaccharide changes on platelet release of vascular endothelial growth factor and thromobospondin-1 in patients with cirrhotic portal hypertension after TIPS procedure / 中华肝脏病杂志

Objective: To investigate the effects of plasma lipopolysaccharide (LPS) concentration changes on platelet release of vascular endothelial growth factor (VEGF) and thrombospondin (TSP)-1 in patients with decompensated cirrhotic portal hypertension after transjugular intrahepatic portosystemic shunt (TIPS) procedure. Methods: 169 cases with cirrhotic portal hypertension were enrolled, of which 81 cases received TIPS treatment. LPS, VEGF, and TSP-1 concentrations with different Child-Pugh class in peripheral blood plasma of patients were measured. After pre-incubation of normal human platelets with different concentrations of LPS and stimulated by collagen in vitro, platelet PAC-1 expression rate, VEGF, and TSP-1 concentrations were detected. PAC-1 expression rate and the concentrations of LPS, VEGF and TSP-1 in peripheral blood plasma of patients before and after TIPS procedure were detected. The relationship between plasma LPS, VEGF and TSP-1 concentrations and Child-Pugh score changes in patients after TIPS procedure was analyzed. Statistical analysis was performed by t-test, one-way ANOVA or Pearson's rho according to different data. Results: Plasma LPS and TSP-1 concentrations were significantly higher in Child-Pugh class C patients than class A and B, but the concentration of plasma VEGF was significantly lower than class A and B (P < 0.01). In vitro experiments showed that concentration of LPS, TSP-1, and platelet PAC-1 expression rate was higher in the supernatant, but the difference in the concentration of VEGF in the supernatant was not statistically significant. Portal vein pressure and platelet activation were significantly decreased (P < 0.01) in patients after TIPS procedure. Portal venous pressure, platelet activation, plasma LPS, and TSP-1 levels were significantly decreased continuously, while VEGF levels were significantly increased continuously after TIPS procedure. Plasma LPS concentration was positively correlated with TSP-1 concentration (r = 0.506, P < 0.001), and negatively correlated with VEGF concentration (r = -0.167, P = 0.010). Child-Pugh score change range was negatively correlated with change range of plasma VEGF concentration (r = -0.297, P = 0.016), and positively correlated with change range of plasma TSP-1 concentration (r = 0.145, P = 0.031) after TIPS. Conclusion: Portal venous pressure gradient, plasma LPS concentration and corresponding platelet activation was decreased in cirrhotic portal hypertension after TIPS procedure, and with TSP-1 reduction and VEGF elevation it is possible to reduce the liver function injury caused by portal venous shunt.

Analysis of Differential Proteins Related to Platelet Activation in Patients with Essential Thrombocythemia Based on Label-Free Quantitative Technology / 中国实验血液学杂志

OBJECTIVE@#To analysis the specific protein markers of essential thrombocythemia (ET) based on proteomics technology, to explore and verify the differential protein related to platelet activation.@*METHODS@#Blood samples were obtained from ET patients and healthy people and a certain protein mass spectrometry was detected using label-free quantitative technology. The proteins relative abundance increased or down-regulated by 1.3 times in the disease group compared with the control group, and the protein abundance in the two groups t test P＜0.05 were defined as differential proteins. Bioinformatics analysis of the differential proteins was performed using GO and KEGG. The difference in the average protein abundance between the two groups was analyzed by t test and P＜0.05 was considered statistically significant. Differential proteins were selected for verification by parallel reaction monitoring (PRM) technology.@*RESULTS@#A total of 140 differential proteins were found, of which 72 were up-regulated and 68 were down-regulated. KEGG enrichment showed that the differential protein expression was related to the platelet activation pathway. The differential proteins related to platelet activation were GPV, COL1A2, GP1bα, COL1A1 and GPVI. Among them, the expressions of GPV, GP1bα and GPVI were up-regulated, and the expressions of COL1A2 and COL1A1 were down-regulated. PRM verification of COL1A1, GP1bα, GPVI and GPV was consistent with LFP proteomics testing.@*CONCLUSION@#Differential proteins in ET patients are related to platelet activation pathway activation.Differential proteins such as GPV, GPVI, COL1A1 and GP1bα can be used as new targets related to ET platelet activation.

Exploration on the preparation conditions of platelets as samples for biomarker detection / 中国输血杂志

【Objective】 To optimize the preparation conditions of platelets as biomarkers to ensure the preparation of platelet samples with low activation and good stability. 【Methods】 The platelet count, platelet activation rate and the count of residual leukocytes were compared among the control and four experimental groups with different centrifugation conditions (120g 10 min vs. 120g 15 min vs.120g 20 min vs.240g 20 min)and different formulations of protective solution, i.e.apyrase, dipyridamole, cilostazol and L-arginine (experimental group 1) vs.apyrase, dipyridamole, cilostazol and adenosine (experimental group 2) vs.apyrase, cilostazol, L-Arginine and adenosine (experimental group 3) vs. apyrase, dipyridamole, L-arginine and adenosine (experimental group 4). 【Results】 Platelets obtained by centrifugation at 120 g for 15 min(73.88±5.36) and centrifugation at 120 g for 10 min(77.65±3.07) had higher recovery rates than other experimental groups(52.77±7.86 and 37.71±13.82)(P0.05). The residual leukocytes in the experimental group centrifuged at 120g for 15 min was slightly lower than that in the experimental group centrifuged at 120 g for 10 min, with no statistical differences (P>0.05). The platelet activation rates of four experimental groups were all significantly lower than that of the control within 72 hours (P0.05). 【Conclusion】 For preparing platelets as biomarker samples, the group with solution including apyrase, dipyridamole, cilostazol and L-arginine, and centrifugation at 120 g for 15min, showed the minimum residual leukocytes and the optimum stability within 72 hours.

Strategies and reflections on platelet-based targeted therapy for tumor / 药学学报

In the past few decades, our understanding of platelets has made great progress. Platelets play an unexpected central role in cancer and greatly affect the behavior of cancer cells. At the same time, the physiology and phenotype of platelets are also affected by cancer cells. Therefore, platelet-based tumor targeted therapy strategies have attracted the attention of researchers, but the limitations of their application require more attention. In this paper, the strategies of platelet-based tumor targeted therapy are summarized, and the strategies of platelet mimicking nanocarrier delivery, platelet hitch riding, platelet membrane coating biomimetic and engineered platelet targeting are mainly introduced. The easy activation, hard storage and unknown functional and phenotypic changes of platelets were discussed. At the same time, the strategy of platelet-based targeted tumor therapy is reviewed from theoretical basis and practical application. The development potential of platelets in the field of tumor diagnosis and treatment is discussed, which will provide some theoretical reference for the study of platelet-related tumor diagnosis and targeted therapy.

Research progress of change of platelet in blood stasis syndrome and effect of traditional Chinese medicine / 中国中药杂志

The traditional Chinese medicine(TCM) syndrome of blood stasis refers to blood stagnation in meridians and viscera, with the main symptoms of pain, mass, bleeding, purple tongue, and unsmooth pulse. Cardiovascular and cerebrovascular diseases are among the major chronic diseases seriously harming the health of the Chinese. Among the coronary heart disease and stroke patients, most demonstrate the blood stasis syndrome. Platelet is considered to be one of the necessary factors in thrombosis, which closely relates to the TCM syndrome of blood stasis and the occurrence of cardiovascular and cerebrovascular diseases. The clinical and laboratory research on platelet activation and aggregation has been paid more and more attention. Its purpose is to treat and prevent blood stasis syndrome. In this study, the authors analyzed the research on the dysfunctions of platelets in blood stasis syndrome, biological basis of TCM blood stasis syndrome, and the effect of blood-activating stasis-resolving prescriptions on platelets, aiming at providing a reference for exploring the mechanism of platelet intervention in the treatment of TCM blood stasis syndrome and the pathways and targets of Chinese medicine in the prevention and treatment of the syndrome.

Activation, function and metabolismofapheresis platelets during storage / 中国输血杂志

【Objective】 To analyze the changes of activation, function and metabolism of apheresis platelets during storage. 【Methods】 Five groups of apheresis platelets(n=10per group), stored up to 5 days at 20~24℃ with agitation, were sampledat day0(4 hours within collection), 1, 2, 3 and 4, respectively to assess the activation indexes as PAC-1 and CD62P and platelet function was evaluated by thromboelastogram.The platelet counts and related parameters were determined, and the biochemical indexes such as pH, glucose, lactic acid and lactate dehydrogenase reflecting metabolism were measured and statistically analyzed. 【Results】 The CD62P (%) and PAC-1 (%) of apheresis platelets with different storage duration showed significant differences(P0.05). Significant differences were notable in platelet biochemical indexesby groups using variance analysis(P<0.05). The pH value and glucose were the lowest in platelets with 4-day storage, while lactic acid and lactate dehydrogenase were the highest. 【Conclusion】 The storagelesion of apheresis platelets occurs as the activation, function and metabolism of platelets developed as the storage prolonged.

Concentration of growth factors in platelet rich plasma under different activators / 中国输血杂志

【Objective】 To study the effects of different activators and doses on the concentration of growth factor in platelet rich plasma(PRP). 【Methods】 15 healthy volunteers, recruited to prepare PRP by COM.TEC blood cell separator, were divided into 5 groups: PRP group with no activator, Calcium gluconate PRP group, Thrombin 100U/ mL-PRP group, Thrombin 50U/ mL-PRP group, and Thrombin 100U/ml-calcium gluconate -PRP group. The white blood cell count and platelet count in PRP and whole blood were detected. The concentrations of PDGF-AA, TGF-βand VEGF in PRP inactive group and 4 different activators 1 hour after activation were determined by ELISA. 【Results】 The mean concentration of platelets in PRP was 1 462.86×109/L, which was 5.77 times that in the whole blood. The mean concentrations (pg/mL) of PDGF-AA(174 348.00±132 872.39 vs 217 909.67±182 517.96 vs 221 020.38±153 321.51 vs 208 550.35±177 100.47), TGF-β(12 573.14±3 173.20 vs 14 678.45±5 880.96 vs 14 694.39±5 083.90 vs 12 675.65±4 981.83) and VEGF (653.45±489.82 vs 671.61±506.68 vs 690.05±416.13 vs 678.93±501.07) in 4 different activator groups were significantly higher than those in inactivated group (P<0.05). There was no significant difference in the concentrations of PDGF-AA, TGF-βand VEGF among different activators. Platelet concentration(1 462.86±628.41×109/L) in PRP had a strong positive correlation with PDGF concentration (221 020.38±153 321.51 pg/mL)in thrombin 50 U/ mL-PRP group (P<0.05) and TGF-βconcentration(pg/mL) (12 573.14±3 173.20 vs 14 678.45±5 880.96 vs 14 694.39±5 083.90 vs 12 675.65±4 981.83, respectively) in four different activator groups (P<0.05), but had no correlation with VEGF in each group. 【Conclusion】 PRP was prepared by blood cell separator with high purity. There was no difference in the concentrations of PDGF-AA, TGF-βand VEGF among different activators and different thrombin doses. The correlation between platelet concentration and growth factor concentration in PRP was related to the type of activator and growth factor.

Changes in Platelet Indices in Obese and Non-Obese Individuals in a Tertiary Healthcare Facility in Uyo, Nigeria

Background: Obesity is associated with significant cardiovascular and thromboembolic risk largely due to increased plateletreactivity. Objectives: To determine the changes in platelet counts and platelet activation using platelet indices (MPV & PDW) inobese and non-obese patients in a tertiary hospital in Uyo, Nigeria.Methodology: This was a cross-sectional descriptive studycomprising of 191 participants recruited consecutively from the out-patients Departments of University of Uyo Teaching Hospitalover a six months period (March-August 2018). Patients were categorised into obese, overweight and normal weight based ontheir Body Mass Index (BMI). Also, 2.5mls of blood was collected from each patient and same was used to determine full bloodcount from where the platelet count and platelet indices (MPV & PDW) were obtained. Results: There was progressive increasein the mean platelet count of the patients (210.59 ± 51.6, 194.26 ± 49.8, 184.95 ± 51.7 for obese, overweight and normal weightrespectively) and this increase was statistically significant (P=0.0208). However, the mean platelet indices (MPV & PDW) wasnot statistically significant (P=0.351 and 0.933 for MPV and PDW respectively). Conclusion: Platelet counts was significantlyelevated in obese patients compared with the overweight and normal weight however, the MPV and PDW was not significantlydifferent in the three groups.

Aspirin & clopidogrel non-responsiveness & its association with genetic polymorphisms in patients with myocardial infarction

Background & objectives: Cytochrome P450, P2Y 12, cyclooxygenase-1 (COX1) and glycoprotein V1 (GPVI) gene polymorphisms are known to affect patient responsiveness towards aspirin and clopidogrel dual antiplatelet therapy (DAPT). The present study was undertaken to identify aspirin and clopidogrel non-responsiveness and its association with genetic polymorphism in patients with myocardial infarction (MI). Methods: A total of 207 MI patients who were on DAPT, were included. The DAPT non-responsiveness was determined by light transmittance aggregometry using arachidonic acid and adenosine diphosphate and high platelet reactivity by collagen. Platelet activation biomarkers, thromboxane B2 (TxB2)andsoluble CD40 ligand (sCD40L) were measured in plasma. Patient compliance was checked by estimating drug and its metabolite levels (aspirin and clopidogrel) in plasma using liquid chromatography-mass spectrometry/mass spectrometry. Genomic DNA was extracted, amplified by polymerase chain reaction and subsequently sequenced to identify CYP450, P2Y 12, COX1 and GPVI gene polymorphisms. Results: Of the 207 patients, 32 were non-responders. The DAPT non-responsiveness was found in 15.5 per cent patients. The non-responsiveness showed a significant and an independent association with gender [odds ratio (OR)=0.18, 95% confidence interval (CI)=0.01-0.78, P=0.023], TxB2(OR=1.00, 95% CI=1.00-1.01, P=0.013), CYP2C19*2 G>A (OR=3.33, 95% CI=1.04-10.69, P=0.044) and GPVI T>C (OR=0.23, 95% CI=0.08-0.67, P=0.007) after adjusting the demographic, clinical and genetic confounding factors when assessed between non-responder and responder compliant patients. Interpretation & conclusions: The study showed a significant association of genetic polymorphisms (CYP2C19*2 G>A and GPVI T>C) with DAPT non-responsiveness in MI patients. The findings of this study need further validation in a large cohort of patients with clinical follow up.

Low triiodothyronine syndrome is associated with platelet function in patients with nephrotic syndrome

SUMMARY OBJECTIVE The objective of this study was to investigate the effects of low triiodothyronine syndrome (LT3S) on platelet function and clotting factors in patients with nephrotic syndrome(NS). METHODS Patients with primary nephrotic syndrome were divided into two groups, normal thyroid function (group A) and LT3S (group B), based on whether they had LT3S or not. Healthy subjects were selected as the control group (group C). Blood coagulation function was detected in each group. The platelet activation function (CD62P, CD63) was determined by flow cytometry. The platelet aggregation rate was detected by an optical method using adenosine diphosphate and arachidonic acid as inducers. RESULTS The proportion of primary nephrotic syndrome with LT3S was 23.2% (69/298). Compared with group C, group A had higher CD62P and PAgTADP, and group B had higher CD62P, CD63, PAgTAA, and PAgTADP; the difference was statistically significant (all P < 0.05). There was no significant difference in renal pathology between group A and group B (X2 = 4.957, P = 0.421). Compared with group A, the 24-hour urine protein, CD63, PAgTAA, and PAgTADP were higher in group B, and APTT and Alb were lower. The difference was statistically significant (P < 0.05). Logistic regression analysis showed that LT3S was associated with CD36 (OR: 3.516; 95% CI: 1.742~8.186; P = 0.004) and PAgTAA (OR: 0.442; 95% CI: 1.001~1.251; P = 0.037). CONCLUSION NS patients are prone to LT3S. Patients with LT3S may have abnormal platelet activation and increase of platelet aggregation.

RESUMO OBJETIVO O objetivo deste estudo foi investigar os efeitos da síndrome do baixo triiodotironina (LT3S) na função plaquetária e nos fatores de coagulação em pacientes com síndrome nefrótica (SN). MÉTODOS Pacientes com síndrome nefrótica primária foram divididos em dois grupos, função tireoidiana normal (grupo A) e LT3S (grupo B), com base na presença ou não de LT3S. Indivíduos saudáveis foram selecionados como grupo de controle (grupo C). A função de coagulação do sangue foi analisada em cada grupo. A função de ativação plaquetária (CD62P, CD63) foi determinada por citometria de fluxo. A taxa de agregação plaquetária foi detectada por um método óptico usando adenosina difosfato e ácido araquidônico como indutores. RESULTADOS A proporção de síndrome nefrótica primária com LT3S foi de 23,2% (69/298). Em comparação com o grupo C, o grupo A apresentou níveis mais altos de CD62P e PAgTADP, e o grupo B apresentou maiores CD62P, CD63, PAgTAA e PAgTADP; a diferença teve significância estatística (P < 0,05). Não houve diferença significativa na patologia renal entre o grupo A e o grupo B (X2 = 4,957, P = 0,421). Em comparação com o grupo A, a proteína em urina de 24 horas, CD63, PAgTAA e PAgTADP foram maiores no grupo B, já APTT e Alb foram mais baixos. A diferença apresentou significância estatística (P < 0,05). A análise de regressão logística mostrou uma associação entre LT3S e CD36 (OR: 3,516; 95% IC: 1,742~8,186; P = 0,004) e PAgTAA (OR: 0,442; 95% IC: 1,001~1,251; P = 0,037). CONCLUSÃO Pacientes com síndrome nefrótica estão propensos à síndrome do baixo triiodotironina (LT3S). Pacientes com LT3S podem ter ativação plaquetária anormal e aumento da agregação plaquetária.

The correlation between chorioamnionitis-induced abnormal placental microvessel and platelet metabolism of preterm infants / 中华实用儿科临床杂志

Objective@#To observe the effect of chorioamnionitis on placental microvessel and platelet metabolism in premature and the correlation between them.@*Methods@#With clinical randomized controlled trial (RCT), the cases were matched by 11 according to gestational ages and divided into 2 groups according to the placental pathology results: chorioamnionitis group and control group, 32 cases in each group.Dates were obtained for preterm infants (gestational age<37 weeks) admitted to the Department of Neonatology at Guangdong Women and Children Hospital, born between June and December 2016.The platelet parameter [platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT)], birth weight, thrombocytopenia, hemorrhage complication, miscrovascular density (MVD) in placenta, platelet activating factors (CD62p, CD63) and thrombopoietin (TPO) in preterm infants were recorded and compared.@*Results@#In chorioamnionitis group, the infant birth weight[(1.90±0.41) kg vs.(2.31±0.62) kg] and the PLT in 72 hours [<24 h (197.97±63.43)×109/L vs.(266.34±69.92)×109/L; 24-72 h (202.28±29.70)×109/L vs.(256.38±69.96)×109/L] were significantly lower compared with the control group, and the differences were statistically significant(all P<0.05). The incidence of early thrombocytopenia(37.50% vs.9.38%), intracranial hemorrhage(40.62% vs.15.63%), MPV [(8.73±0.89) fL vs.(8.27±0.64) fL] and PDW[(59.46±5.90)% vs.(55.20±5.37)%] in 24 hours were significantly higher in chorioamnionitis group, and the differences were statistically significant (all P<0.05). The placental MVD in chorioamnionitis group significantly decreased[(9.08±1.35)% vs.(12.89±1.36)%, P<0.05 ]. The level of CD62p, CD63 and TPO in umbilical cord blood were significantly higher in chorioamnionitis group[(25.37±5.20)% vs.(10.35±2.94)%, (9.49±1.58)% vs.(4.04±1.21)%, (271.08±197.22) μg/L vs.(141.87±78.10) μg/L, all P<0.05]. The placental MVD was positively associated with PLT (r=0.74, P<0.05) and negatively associated with CD62p, CD63 and TPO among infants with chorioamnionitis (r=-0.64, -0.44, -0.44, all P<0.05).@*Conclusions@#The chorioamnionitis may decrease the MVD in placenta and activate platelet in fetal circulation, damaged placental microvessel may activate platelet further.

Thrombosis Prediction of a Catheter Pump Based on Simulation Method / 医用生物力学

Objective To investigate a self-designed catheter pump by using computational fluid dynamics (CFD) method, so as to predict its hydraulic performance and risk of thrombosis formation. Methods The thrombosis prediction models proposed by Grigioni and Danny Bluestein were used. The shear stress and exposure time during platelet motion were calculated by CFD method, and parameters of platelet activation state (PAS) were obtained for prediction of thrombogenic performance. Results At the flow rate of 4 L/min and rotating speed of 10 000 r/min, the differential pressure of the pump reached 14.763 kPa and the hydraulic performance was proved to fit the requirement of left ventricular assist device. The PAS values of Grigioni model and Danny Bluestein model were 6.35×10-6 and 7.68×10-4,respectively, both at a very low level, indicating a low possibility of thrombus formation. Conclusions This study investigated the feasibility of thrombosis prediction based on simulation method and the predicted hydraulic performance and thrombosis will provide references for further design optimization.