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.

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.

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.

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.

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)

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.

Changes of blood coagulation indicators in patients with lymphoplasmacytic lymphoma and their clinical significances / 白血病·淋巴瘤

Objective To observe the alteration and clinical significances of blood coagulation indicators in patients with lymphoplasmacytic lymphoma (LPL). Methods Twenty patients who were newly diagnosed LPL in the First People's Hospital of Changzhou from January 2008 to October 2017 and twenty healthy controls were studied. The patients were treated by chemotherapy, plasma exchange, supplement of coagulation factor or other supportive therapy. The parameters of prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), thrombin time (TT), D-dimer (D-D), and platelet count (Plt) were detected in LPL group and healthy controls. Results The levels of PT and APTT in LPL group were dramatically higher than those in control group [(12.9±1.2) s vs. (11.6±0.9) s, (41.7±9.8) s vs. (24.7±2.9) s], and the level of Plt in LPL group was lower than that in control group [112×109/L (3×109/L - 379×109/L) vs. 210×109/L (170×109/L - 271×109/L)], and the differences were statistically significant (all P< 0.05). There were no significant differences in FIB, TT and D-D levels between LPL group and control group (all P ＞0.05). There were no statistical differences in PT, APTT, FIB, TT, D-D and Plt levels among LPL patients with different types of immunoglobins (all P ＞ 0.05). After treatment, all the coagulation abnormalities got relieved and no patient died of hemorrhage or thrombosis. Conclusions The LPL patients have coagulation disorders and hypercoagulability, and this is independent of the type of immunoglobulin. Clinical attention should be paid to monitoring coagulation indicators to prevent the occurrence of adverse reactions.

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.

Anticoagulant effects of phytotherapeutic drugs and their importance in surgical dental procedures / Efeitos anticoagulantes de drogas fitoterapicas e sua importância em procedimentos odontológicos cirúrgicos

ABSTRACT Phytotherapeutic drugs are plant-derived products with medicinal properties. They are used for treating or preventing several diseases. However, patients who use these substances and even health professionals are unaware of their negative effects. One of the most common negative effects of phytotherapeutic drugs reported in the literature is the inhibition of natural coagulation factors in the human body. Therefore, the aim of this study was to perform a brief review of the literature concerning the anticoagulant effects of phytotherapeutic drugs and their importance in surgical dental procedures. Preventive measures, clarification and monitoring of patients taking phytotherapeutic drugs are recommended before performing surgical dental procedures, in order to prevent against complications such as hemorrhage.

RESUMO Fitoterápicos são produtos derivados de plantas com propriedades medicinais. Eles são utilizados para o tratamento ou a prevenção de diversas doenças. No entanto, os pacientes que fazem uso destas substâncias, na sua grande maioria, desconhecem seus efeitos negativos. Portanto, o objetivo deste estudo foi realizar uma breve revisão de literatura sobre os efeitos anticoagulantes de fitoterápicos e sua importância diante da realização de procedimentos odontológicos cirúrgicos. Medidas de prevenção, esclarecimento e acompanhamento de pacientes que se utilizam destes medicamentos são recomendados antes da realização destes procedimentos a fim de prevenir complicações como processos hemorrágicos.

Perfil clínico y epidemiológico de pacientes con hemofilia registrados en la Liga de Hemofílicos de Antioquia (Colombia) / Clinical and epidemiological profile of patients with hemophilia in Liga de Hemofilicos de Antioquia (Colombia)

Introducción: La hemofilia es una enfermedad hemorrágica hereditaria caracterizada por la ausencia o deficiencia de factores VIII y IX de la coagulación. Objetivo. Determinar el perfil clínico y epidemiológico de los pacientes con hemofilia registrados en la liga de hemofílicos de Antioquia (LIHEA) durante 2005-2011. Metodología. Estudio descriptivo transversal, la población fueron pacientes con hemofilia de la LIHEA que cumplieron con criterios de selección. Se diseñó un instrumento de recolección de información y se aplicó el instrumento Modelo de actitud en pacientes con hemofilia (MAPACHE). Las variables cuantitativas se analizaron con medidas de tendencia central y dispersión, a las variables cualitativas se les estimó frecuencias absolutas, proporciones y razones. Resultados. Se incluyeron 36 hombres con hemofilia, con una mediana de 22 años de edad. En cuanto a los antecedentes personales los más frecuentes fueron HTA (8.3%) y tromboflebitis (5.6%). El sedentarismo fue el factor de riesgo de estilo de vida más común (8.3%). Las manifestaciones clínicas más frecuentes fueron hemartrosis (94.4%), hematomas musculares (80.6%) y equimosis (77.8%). En la mitad de los pacientes la enfermedad generó algún tipo de discapacidad, siendo la más frecuente la física (44.4%). El tratamiento farmacológico más frecuente fue profilaxis con factor VIII con un 88.9%, acompañado de la natación como principal tratamiento no farmacológico con un 77.8%. En cuanto al MAPACHE el 30.6% manifestó una actitud negativa hacia la enfermedad, un 5.6% fue neutra y para el 63.9% restante fue positiva. Conclusión. La hemofilia tuvo grandes repercusiones físicas y emocionales para los pacientes estudiados que la padecen

Introduction: Hemophilia is a hereditary hemorrhagic disorder characterized by the absence or deficiency of factors VIII and IX of the coagulation. Objective. To determine the clinical and epidemiological profile of patients with hemophilia recorded in the Liga de Hemofilicos de Antioquia (LIHEA) during 2005-2011. Methodology. Descriptive transversal study, population were patients with hemophilia from LIHEA which met selection criteria. We designed a data collection instrument and applied the attitude instrument in patients with hemophilia (MAPACHE). The quantitative variables were analyzed using measures of central tendency and dispersion, the qualitative variables were estimated absolute frequencies, proportions and reasons. This research had the respective ethical guarantee. Results. We included 36 men with hemophilia, with a median of 22 years of age. In terms of the personal history, the most frequent were hypertension (8.3%) and thrombophlebitis (5.6%). Sedentariness was the most common lifestyle risk factor (8.3%). The most frequent clinical manifestations were hemarthrosis (94.4%), muscle hematomas (80.6%) and ecchymosis (77.8%). In half of the patients, disease generated some kind of disability, being the most common the physics (44.4%). The most common drug treatment was prophylactic factor VIII with 88.9 %, accompanied by swimming as the main non-pharmacological treatment with 77.8 %. Respect MAPACHE, the 30.6% expressed a negative attitude towards the disease, a 5.6% was neutral and the 63.9% was positive. Conclusion. Hemophilia is still a disease of great physical and emotional implications for studied patients who suffer it

Treatment of hemorrhagic transformation in patients with ischemic stroke / 国际脑血管病杂志

10% to 15% of patients with ischemic stroke may have hemorrhagic transformation.Its treatment is more complex,mainly includes blood pressure management,reversing coagulopathy,and treatment of complications (including increased intracranial pressure).The current research is mainly to find the therapeutic regimen of hemorrhagic transformation after anticoagulation and thrombolytic therapy in order to improve the prognosis in patients with stroke.

Changes of coagulation and fibrinolysis function and PLT in patients with lung cancer before and after ;chemotherapy / 中国基层医药

Objective To investigate the changes of blood coagulation and fibrinolytic function and PLT in patients with lung cancer before and after chemotherapy,and to investigate the changes of the patients with lung cancer and the influence of the changes with lung cancer and the prognosis.Methods 40 patients with lung cancer(observation group)treated in our department from March 2012 to May 2014 were selected as the research subjects.The changes of coagulation and fibrinolytic activity,PT(PTINR),APTT,thrombin time(Fib),thrombin time(D -D),thrombin time (TT),D -D,and PLT were analyzed.The relationship between the parameters and the lung cancer staging was analyzed. Results Before chemotherapy,the levels of Fib,PLT,D -D,PT,PTNR,APTT,TT,PLT were (11.34 ±1.14)s, (1.01 ±0.07),(24.34 ±4.53)s,(2.54 ±0.45)g/L,(184.31 ±10.88)×109 /L,(143.35 ±23.45)ng/mL, (14.55 ±4.56)s.After chemotherapy,the levels of Fib,PLT,D -D,PT,PTNR,APTT,TT,PLT were (11.57 ± 1.36)s,(1.03 ±0.05),(24.52 ±5.32)s,(3.63 ±0.65)g/L,(210.45 ±11.24)×109 /L,(126.56 ±26.55)ng/mL, (14.34 ±4.17)s.The contents of Fib and PLT after chemotherapy were higher than before chemotherapy(t =0.024, 0.025,all P 0.05).Compared with patients with stage Ⅰ ~Ⅱ lung cancer,Fib level in stage Ⅲ ~Ⅳ lung cancer was higher (t =0.01,P 0.05).Conclusion PLT and Fib were increased,but D -D decreased after chemotherapy,the tumor remission rate was higher in D -D group,which indica-ted that the levels of Fib and D -D should be changed in the course of clinical chemotherapy.

The activity of factor VIII and IX of cord blood at mid-trimester in fetuses without hemophilia

PURPOSE: Molecular genetic analysis is the main approach used for prenatal diagnosis of hemophilia A and B. However, in certain cases, such analysis is uninformative. In such situations, direct measurement of fetal coagulation factor levels is still the best option, and it may be the only option in some cases. This study was conducted to determine the normal ranges of midtrimester cord blood factor VIII (FVIII) and IX (FIX) in a Korean population. MATERIALS AND METHODS: Twenty-six FVIII samples and 29 FIX samples were assayed in fetal cord blood acquired by ultrasound-guided cordocentesis. Sampling was conducted during gestational ages of 19-24 weeks. RESULTS: The mean and standard deviations for FVIII and FIX activity were 45.5±30.5% and 19.9±12.2%, respectively. Ranges for FVIII and FIX were 1.5-125.0% and 6.0-52.0%, respectively. CONCLUSION: Our study revealed the normal ranges and lowest level of factor VIII and factor IX in non-affected normal fetus by fetal cord blood sampling during the mid-trimester in a Korea population. The factor assay of the fetal cord blood is invasive but feasible and provides important basic data related to hemophilia.

Hepatic oxidative stress and coagulation status in rat model of pulmonary emphysema combined with intermittent hypoxia / 天津医药

Objective To establish the rat overlap syndrome (OS) model of intermittent hypoxia (IH) combined with pulmonary emphysema and to explore its connection with hepatic oxidative stress, inflammatory status in the live and coagu?lation profile. Methods Male Wistar rats (n=60) were randomly divided into four groups:control group (A), IH group (B), pulmonary emphysema group (C) and OS group (D). The rat model of pulmonary emphysema was established by exposing rats in smoke for 16 weeks. From the 13th week, pre-programmed intermittent hypoxia/re-oxygenation (IH/ROX) exposure was given in the meantime of smoke exposure in OS group. Liver tissues were sectioned or triturated for pathological scoring or for detecting expression levels of superoxide dismutase (SOD), catalase (CAT) and malondialdehyde (MDA) respectively. Se?rum levels of coagulant/anticoagulant factors such as antithrombin (AT), fibrinogen (FIB), von Willebrand factor(vWF) and FactorⅧ(FⅧ) were also evaluated using biochemistry analysis. Results The levels of pathological scores and coagulant factors(FIB, FⅧ:C and vWF:Ag)were significantly higher in group D than those in group A, B and C. The values of SOD, CAT and AT were significantly lower in group D than those in other three groups. Serum levels of FIB, vWF:Ag, FⅧ:C and AT:A correlated with SOD(r equal to-0.905、-0.941、-0.946 and 0.817 respective,P<0.01). Conclusion In rat overlap syndrome when IH combined with pulmonary emphysema, hepatic inflammation and coagulability present mutual promotion effect and produce a more significant liver-derivative inflammatory and prothrombotic status.