ABSTRACT
【Objective】 To investigate whether the blood donors' coagulation status may lead to apheresis platelet aggregation in vitro. 【Methods】 Thirty blood donors with aggregation in apheresis platelets collected by AMICUS blood cell separator no less than 3 times previously and occurred when the last time of apheresis donation were observed in aggregated group (referred to as the experimental group); Thirty donors without aggregation in apheresis platelets collected by AMICUS blood cell separator no less than 3 times were observed in the control group simultaneously. The basic platelet parameters in the two groups, including Plt, MPV, PDW, Pet, P-LCR were detected by automatic blood cell analyzer (BC-3000Plus), and thromboelastogram indexes including reaction time(R), kinetics time(K), kinetics of clot development(α), maximum amplitude (MA) and coagulation index(CI) were tested by Thrombosis elastography (TEG) before collection. With SPSS24.0 software, t test was used to compare the differences between the two groups. 【Results】 The CI value in experimental group was significantly different from that of the control group (0.48± 1.00 vs -0.99 ±1.96, P0.05 ) . 【Conclusion】 The coagulation status of blood donors may be an independent risk factor for the in vitro aggregation of apheresis platelets.
ABSTRACT
Objective:To explore the changes of coagulation index levels in patients with type 2 diabetic foot and their correlation with pathological changes, in order to provide reference for clinical diagnosis of diabetic foot.Methods:133 patients with type 2 diabetes admitted to the Xiaoshan Hospital of Traditional Chinese Medicine in Hangzhou from Jun. 2018 to Jun. 2020 were selected. The patients were divided into type 2 diabetes group ( n=65) and diabetes foot group ( n=68) according to whether they had diabetes feet. In addition, 60 patients who had health examinations in our hospital during the same period were selected as the control group. Fibrinogen (FIB), thrombin time (TT), activated partial thromboplastin time (APTT) and prothrombin time (PT) were compared in each group, and Spearman method was used to analyze the correlation between each index and the occurrence of diabetes foot. Area under curve (AUC) of working characteristics of subjects (ROC) was used to analyze the diagnostic value of each index in diabetes foot. Results:The average FIB of control group, type 2 diabetes group and diabetes foot group was (2.86±0.50) g/L, (3.30±0.81) g/L, (4.43±1.16) g/L; The FIB level in diabetes foot group was significantly higher than that in type 2 diabetes group and control group, and that in type 2 diabetes group was significantly higher than that in control group ( P<0.05) ; The mean TT of control group, type 2 diabetes group and diabetes foot group was (17.60±2.01) s, (15.39±2.39) s, (13.49±2.84) s; The average APTT of control group, type 2 diabetes group and diabetes foot group was (32.02±4.22) s, (29.97±3.97) s, (25.69±4.07) s; The mean PT values of control group, type 2 diabetes group and diabetes foot group were (12.64±1.49) s, (11.41±1.04) s and (10.50±1.08) s. The TT, APTT and PT values in the diabetes foot group were significantly lower than those in the type 2 diabetes group and the control group, and those in the type 2 diabetes group were significantly lower than those in the control group ( P<0.05) ; The level of FIB index was positively correlated with the occurrence of diabetes foot, while TT, APTT and PT indexes were negatively correlated with the occurrence of diabetes foot ( P<0.05). The AUC values of FIB, TT, APTT and PT indexes for the diagnosis of diabetes foot were 0.898, 0.879, 0.859 and 0.871, respectively. Conclusions:There are significant differences in FIB, TT, APTT and PT index levels between diabetic foot patients and type 2 diabetic patients and healthy people, and the occurrence of diabetic foot is significantly related to blood coagulation indicators. The detection of blood coagulation indicators has certain clinical significance for the diagnosis of diabetic foot.
ABSTRACT
@#Abstract: Objective To analyze the changes of coagulation indicators in patients with hepatitis B complicated with Clonorchis sinensis (C. Sinensis), and provide reference value for diagnosis, drug using and prognosis monitoring. Methods The patient samples were collected from the Third Affiliated Hospital of Sun Yat-sen University from June 2018 to February 2022 and divided into six groups. They were 40 healthy patients, 47 patients with simple chronic hepatitis B, 47 patients with post-hepatitis B liver cirrhosis, 40 patients with C. Sinensis mono-infection, 30 patients with chronic hepatitis B patients co-infected with C. Sinensis and 27 patients with post-hepatitis B liver cirrhosis patients coinfected with C. Sinensis. Four coagulation indexes, prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) and fibrinogen (FIB), were detected and compared among the groups. Results Compared with the healthy group, C. Sinensis mono-infection group had higher level of FIB and delayed PT, APTT; chronic hepatitis B group and chronic hepatitis B patients co-infected with C. Sinensis group had delayed PT, APTT, TT and significant lower FIB, these differences were statistically significant (all P<0.05). Compared with simple chronic hepatitis B group, post-hepatitis B liver cirrhosis and chronic hepatitis B patients co-infected with C. Sinensis had significant delayed PT, APTT, TT and lower FIB (all P<0.05). Compared with the post-hepatitis B liver cirrhosis and chronic hepatitis B patients co-infected with C. Sinensis, post-hepatitis B liver cirrhosis patients coinfected with C. Sinensis group had significant delayed PT, APTT, TT and lower FIB (all P<0.05). Conclusions The coinfection of C. Sinensis will further aggravate the coagulation dysfunction of HBV patients, leading to poor treatment and prognosis. HBV patients will have worse coagulation function in the process to post-hepatitis B liver cirrhosis; Therefore, it is important to pay attention to C. Sinensis co-infection when treating HBV patients, so that further guidance on clinical use and monitoring of prognosis can be provided.
ABSTRACT
Objective:To analyze the microstructure of commonly used surgical hemostatic powders and investigate their hemostatic properties.Methods:The microstructures of seven commonly used surgical hemostatic powders were observed by scanning electron microscopy and analyzed by particle size testing, and then the hemostatic properties of the seven commonly used surgical hemostatic powders were evaluated by an in vitro coagulation promotion test and a rabbit liver bleeding model.Results:The average particle size of Aristide hemostatic powder was 45.143 μm, and there were many grooves on the surface of the particles with increased specific surface area. The results of in vitro coagulation promotion tests showed that the absorbance and coagulation index of Aviagen were the lowest, which were 0.039 30±0.006 03 and 3.42, respectively. The rabbit liver bleeding experiment showed that the hemostatic effect of hemostatic powder materials in the experimental group was better than that in the control group (all P<0.001), among which Aviagen and Aristide were more effective. The hemostatic time and the effective bleeding volume of the experimental group and the control group were (44±17) s and (48±9) s, and (63±19) mg and (73±18) mg, respectively, and the differences were statistically significant (all P<0.05). Conclusions:There are many grooves on the surface of Arista granules, which gives them a better performance in homeostasis in surgical applications. Avitene has lower absorbance and coagulation index, and better hemostatic properties.
ABSTRACT
Objective:To investigate the clinical effect of Jiedu Limai decoction in septic patients with syndrome of heat-toxin exuberance.Methods:A prospective randomized controlled trial was conducted. From March 2019 to April 2020, septic patients with syndrome of heat-toxin exuberance admitted to intensive care unit (ICU) of Shanghai General Hospital and Songjiang Branch of Shanghai General Hospital were enrolled as the research objects, and they were divided into routine treatment group and Jiedu Limai decoction group by the random number table method. Patients in both groups were given standard treatment in accordance with the guidelines, and patients in the Jiedu Limai decoction group were given Jiedu Limai decoction in addition to the standard treatment, once a day for 14 days. The 28-day survival of patients of the two groups were recorded, the acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, sequential organ failure assessment (SOFA) score, coagulation indexes, infection indexes, inflammatory cytokines and organ function indicators before treatment and 7 days after treatment in both groups were recorded, and the prognosis of the two groups were recorded.Results:A total of 259 patients with infection or clinical diagnosis of infection admitted during the experimental observation period were included, and those who did not meet the Sepsis-3 diagnostic criteria, more than 80 years old or less than 18 years old, with multiple tumor metastases, autoimmune system diseases, with length of ICU stay less than 24 hours, with acute active gastrointestinal bleeding and with incomplete data were excluded. One hundred patients were finally enrolled, with 50 patients in the routine treatment group and 50 patients in the Jiedu Limai decoction group. There were no statistically significant differences in coagulation indexes, infection indicators, inflammatory cytokines and organ function indicators before treatment between the two groups. After 7 days of treatment, the coagulation indexes, infection biomarkers and inflammatory cytokines in the Jiedu Limai decoction group were significantly lower than those in the routine treatment group [D-dimer (mg/L): 2.2 (1.8, 8.5) vs. 4.0 (1.5, 8.7), fibrinogen (Fib, g/L): 3.7 (3.4, 4.3) vs. 4.2 (3.7, 4.3), fibrinogen degradation product (FDP, mg/L): 7.2 (5.4, 10.2) vs. 13.2 (9.2, 15.2), procalcitonin (PCT, μg/L): 0.4 (0.2, 2.9) vs. 0.5 (0.2, 0.9), C-reactive protein (CRP, mg/L): 50.1 (9.5, 116.0) vs. 75.1 (23.5, 115.2), interleukin-6 (IL-6, ng/L): 31.6 (21.6, 81.0) vs. 44.1 (14.0, 71.3), all P < 0.05], and the levels of B-type brain natriuretic peptide (BNP) and kidney injury molecule-1 (KIM-1) were significantly lowered [BNP (ng/L): 261.1 (87.5, 360.3) vs. 347.3 (128.8, 439.4), KIM-1 (μg/L): 0.86 (0.01, 1.40) vs. 1.24 (1.05, 1.57), both P < 0.05]. Compared with the routine treatment group, the number of new organ failure in the Jiedu Limai decoction group was decreased (30.0% vs. 50.0%, P < 0.05). Although there was no significant difference in 28-day mortality between the two groups ( P > 0.05), the 28-day mortality in the Jiedu Limai decoction group was lower than that in the routine treatment group (18.0% vs. 24.0%). Conclusion:Combining Jiedu Limai decoction to the sepsis guideline in treating syndrome of heat-toxin exuberance can effectively improve patients' coagulation function, the situation of heart and renal injury, reduce the level of inflammatory cytokines, and fewer people develop new organ failure after treatment.
ABSTRACT
Objective To evaluate the perioperative blood loss and blood transfusion in liver transplantation patients.Methods Retrospectively selected and classified 119 patients with liver transplantation medical recordsaccording to the clinical diagnosis of age,gender.Analyzed (disease)patients' blood coagulation index 24 h before surgery,intraoperative and postoperative perioperative bleeding,and blood red blood cell suspension,frozen plasma,cold precipitation,coagulation factor injection lossplateletpheresis.Results There were no significant differences in the amount of blood loss and the amount of blood preparations duringthe perioperative period of liver transplantation according to the age and sex of patients (P＞0.05);According to the clinical diagnosis of different groups,the diagnostic group (primary liver cancer group,hepatitis B cirrhosis group and severe hepatitis group) patients with a single platelet transfusion dosewas similar (P＞0.05)withsuspended red blood cells (U) at 8.4+11.9,16.2+15.7,18.1+13.5,frozen plasma (U) at 8.2+7.1,18.1+15.6 and 18.2+ 17.9 respectively andcold precipitation (U) at 9.5+ 8.2,17.1 + 16.318.5 + 16.4 (P＜ 0.05);The diagnosis group surgery before and after immediate PT (s) were 15.6+3.8,24.6+4.1,APTT (s) were 44.3+5.8,84.9+9.2,TT (s) were 20.4 +4.5,40.1+6.2,and Fib(s) were 2.6+0.8 and 1.3+0.9 (P＜0.05);however,there was no significant difference in the 24 h PT,APTT,TT and Fib between the two groups after diagnosis (P＞0.05).Conclusion Ascientific,safe and reasonable selection of perioperative blood preparation for clinical diagnosis for different liver transplantation patients is critical to the success rate and prognosis of liver transplantation;the evaluation of coagulation indexes at each interval can help guiding the blood transfusion during liver transplantation.
ABSTRACT
OBJECTIVE:To observe the effects of alprostadil combined with papaverine on blood coagulation indexes and complications in uremic hemodialysis patients after initial arteriovenous fistula.METHODS:One hundred and eighteen uremic hemodialysis patients undergoing initial arteriovenous fistula in our hospital during Feb.-Jun.2015 were divided into control group and observation group according to random number table,with 59 cases in each group.Both groups received local irradiation with hemodialysis internal fistula repair instrument 30 min,tid,from 3 days before surgery to 10 days after surgery.Control group was treated with Alprostadil injection 10 μg,iv,qd,immediately after surgery.Observation group was additionally treated with Papaverine in jection 30 mg,iv,qd,on the basis of control group.Both groups received treatment for 10 d.The orificium fistulae blood flow,hemodialysis blood flow and the time of initial hemodialysis were compared between 2 group.The plasma prothrombin time (PT),activated partial thromboplastin time (APTT),fibrinogen (Fib),platelet count (PLT) and C-reactive protein (CRP) levels were observed in 2 groups before and after surgery.The occarrence of postoperative complications was observed.RESULTS:The orificium fistulae blood flow and hemodialysis blood flow of observation group were significantly higher than those of control group,and ini tial hemodialysis time was significantly shorter than control group,with statistical significance (P＜0.05).Before surgery,there was no statistical significance in PT,APTT,Fib,PLT and CRP between 2 groups (P＞0.05).After surgery,APTT and CRP of 2 groups were increased significantly,Fib was decreased significantly;the above indexes of observation group was significantly better than that of control group,with statistical significance (P＜0.05).There was no statistical significance in PT,PLT between 2 groups (P＞0.05).There was no statistical significance in the incidence of internal fistula infection and postoperative wound bleeding volume＞ 10 mL between 2 groups (P＞0.05).The incidence of internal fistula occlusion and orificium fistulae thrombus in observation group were significantly lower than control group,with statistical significance (P＜0.05).CONCLUSIONS:The application of alprostadil combined papaverine on uremic hemodialysis patients after initial arteriovenous fistula can effectively prevent inflammation reaction,fistula thrombus formation and fistula occlusion,and improve the maturation of fistula.
ABSTRACT
Objective To investigate the changes and clinical significance of the coagulation function after mitral valve replace‐ment (MVR) .Methods 163 cases of MVR admitted in our hospital from January 2012 to January 2014 were included in the obser‐vation group and contemporaneous 163 individuals of healthy physical examination were selected as the control group .The pro‐thrombin time (PT) ,activated partial thromboplastin time (APTT ) ,fibrinogen concentration (FIB) ,thrombin time (TT ) and pro‐thrombin time international normalized ratio (INR) in the two groups were detected and the detected results were performed the statistically comparative analysis .Results PT ,APTT and INR in the majority of the observation group were significantly higher than those in the control group ,the differences had statistical significance (P < 0 .05) .Conclusion The regular determination of blood coagulation function after MVR can effectively reflect the disorder status of anticoagulant and coagulation mechanism ,and can improve the efficiency of diagnosis and treatment and clinical predictive value .
ABSTRACT
Objective To investigate changes of coagulation function in patients with high altitude polycythemia (HAPC) .Meth‐ods Activated partial thromboplastin time (APTT) ,prothrombin time (PT) ,thrombin time (TT) and fibrinogen (Fbg) were de‐tected and compared between 69 patients with HAPC and 60 healthy subjects (controls) .Results Fbg ,APTT and TT levels in pa‐tients with HAPC were higher than controls (P0 .05) .Dynamic obser‐vation indicated that comprehensive therapy could these recover coagulation function .Conclusion Hemorrhage and coagulation process in patients with HAPC could be very complicated ,including physiological adaptation and the process of physiology evolving into pathology .
ABSTRACT
Objective To investigate the relationship between the changes of blood coagulation index before and after neoadjuvant chemotherapy and the chemotherapeutic efficacy in patients with breast cancer.Methods Ninety patients with breast cancer were selected,and detected the changes of blood coagulation index before and after neoadjuvant chemotherapy (TAC regimen),and the relationship between blood coagulation index and the chemotherapeutic efficacy were analyzed.Results The levels of fibrinogen (Fib),platelet count (PLT) after chemotherapy were significantly higher than those before chemotherapy [(3.42 ±0.50) g/L vs.(2.44 ±0.46) g/L,(267.83 ±61.34) × 109/L vs.(174.18 ±48.65) × 109/L] (P ＜ 0.01),D-dimer (D-D) was significantly lower than that before chemotherapy [(176.32 ± 101.41) mg/L vs.(214.55 ± 106.34) mg/L] (P ＜ 0.01).The remaining indicators before and after chemotherapy had no significant differences (P ＞ 0.05).The level of D-D in 68 cases was reduced after chemotherapy,the effective chemotherapy in 53 cases (77.9％,53/68),ineffective in 15 cases (22.1％,15/68);the level of D-D in 22 cases was increased after chemotherapy,the effective chemotherapy in 9 cases (40.9％,9/22),ineffective in 13 cases (59.1％,13/22),the difference was statistically significant (P=0.000).The level of PLT in 10 cases was reduced after chemotherapy,the effective chemotherapy in 3 cases(3/10),ineffective in 7 cases (7/10);the level of PLT in 80 cases was increased after chemotherapy,the effective chemotherapy in 59 cases (73.8％,59/80),ineffective in 21 cases (26.3％,21/80),the difference was statistically significant (P=0.044).Conclusions The Fib and PLT increase while the D-D decreases after chemotherapy,so it is necessary to monitor Fib,PLT,D-D level during chemotherapy.The D-D and PLT are effective indexes in evaluating curative effect of neoadjuvant chemotherapy in patients with breast cancer.
ABSTRACT
Objective To explore the effect of Vitamin K1(Vit K1), fresh frozen plasma (plasma) andcryoprecipitate on prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen original(Fbg), thrombin time (TT) of newborns with different gestational ages. Methods The serum of 1,134 newbornsfrom The Third Affiliated Hospital of Guangzhou Medical University was collected from February 2009 to September2012. All newborns had been divided into four groups (according to the gestational age of 28-31+6 weeks, 32-33+6weeks, 34-36+6 weeks and gestational age≥37 weeks).The effect of various interventions (Vit K1, Vit K1+plasmaand Vit K1+cryoprecipitate) on PT, APTT, Fbg, and TT had been recorded. Results (1)The PT and APTT ofeach group with the interventions of Vit k1 were significantly improved (P < 0.05). (2)The PT, APTT, Fbg and TTof each group with the interventions of Vit k1 combined with plasma were significantly improved (P < 0.05). (3)ThePT, APTT and Fbg of each group with the interventions of Vit k1 combined with cryoprecipitate were significantlyimproved (P < 0.05). (4)With Vit k1 combined with plasma, PT and APTT were mostly improved and Fbg wasimproved mostly with Vit k1 combined with cryoprecipitate. Conclusion Vitamin K1, fresh frozen plasma andcryoprecipitate can effectively improvedin the coagulation index of newborns with different gestational ages.
ABSTRACT
Objective To explore the relationship among the changes of five coagulation indexes and clinical stage,metastasis in pre-operative patients with gastric carcinoma,and to investigate the coagulation in patients with different clinical stages and its clinical significance.Methods Eight hundred and sixty-eight gastric carcinoma patients( carcinoma group) who were firstly diagnosed and 213 patients ( control group) who were diagnosed as inguinal hernia in the same hospital during the same period were enrolled.Levels of rothrombin time (PT),activated partial thromboplastin rime (APTT),fibrinogen (FBG),plasma thrombin time (TT) and platelet count (PLT)were observed and compared in these two groups.Results (1)Compared with health control group,PT( [ 11.51 ± 1.21 ] s vs [ 11.27 ± 0.91 ] s,t =- 3.226,P ＜ 0.01 ),FBG( [ 3010.0 ±470.4] mg/L vs [ 2307.1 ± 651.8 ] mg/L,t =- 4.240,P ＜ 0.01 ) and PLT ( 238.57 ± 78.50 ) x 109/L vs (206.79 ±61.01 ) x 109/L,t =-5.514,P ＜0.01 )were significantly increased in gastric carcinoma group.(2)PT,FBG and PLT were significantly different between control group and different clinical stages of gastric carcinoma group ( P ＜ 0.05 or P ＜ 0.01 ).The levels of APTF,TT exhibited no significant difference between control group and different clinical stages of gastric carcinoma group ( P ＞ 0.05 ).( 3 ) Compared with gastric carcinoma without metastasis group,preoperative blood PT extended significantly ([ 11.41 ± 0.99] s vs [ 11.57 ± 1.32 ]s,t =- 2.095,P ＜ 0.05 ),FBG concentration increased significantly ( [ 2639.1 ± 748.6 ] mg/Lvs [ 3233.2 ± 591.60 ] mg/L,t =- 2.307,P ＜ 0.05 ) and PLT count increased significantly ( [ 224.02 ±76.94] x 109/L vs [ 247.32 ± 78.37 ] x 109/L,t =- 4.299,P ＜ 0.01 ) in gastric carcinoma with metastasis group.(4) Correlation analysis on four coagulation and PLT count with clinical stage:PT ( r =0.071,P ＜ 0.05 ),FBG ( r =0.271,P ＜ 0.01 ) and PLT( r =0.166,P ＜ 0.01 ) were positively correlated with clinical stage of gastric carcinoma and TT( r =- 0.077,P ＜ 0.05 ) was negatively correlated with clinical stage,among the total,the correlation coefficient of FBS with clinical stage was maximum.Conclusion Most patients with gastric cancer present state of blood coagulation and bleeding tendency,particularly in advanced gastric cancer,and with increased clinical stage of gastric cancer,some coagulation indicators showing a rising trend.Detection of coagulation index indirectly indicates the incidence,invasion and metastasis of gastric carcinoma.
ABSTRACT
Objective To expolore the changes of coagulation index in newborns of different age and its clinical significance. Methods We studied 129 newborn infants without complication admitted to the neonatal department in an all-around hospital in Gnangzhou from January to December in 2005. These neonates were divided into two groups, including 63 cases of full-term infants and 66 cases of premature infants. Prothrombin time (PT), activated partial prothrombin time (APTT), Fibrinogen (Fg), thrombin time (TT), D-dimer (D-D) of these newborn infants were assayed on the first day, the third day and the tenth day. Results In the postnatal three periods of time, there was no difference in PT and D-dimer between two groups(P >0.05), but APTT and TT in premature infants were higher than that in full-term infants( P < 0.05), and Fg in premature infants were lower than that of full-term irfants(P<0.05). PT,APTT, TT,Ddimer were in decrease tendency and Fg increased as age increased( P < 0.05 ). Conclusion Geststional age and age had effect on coagulation index in newborn infants, and both can provide clinical references to clinical diagnosis and therapy.