Coagulation Factors for Diagnosis of Periprosthetic Joint Infection / 中山大学学报(医学科学版)

ObjectivePeriprosthetic joint infections （PJI） are currently the most calamitous complication after arthroplasty. Although achievements have been made in many markers for the diagnosis of PJI， the lack of a gold standard remains a great obstacle for early diagnosis. This study aimed to investigate the association between coagulation markers and the development of PJI in patients undergoing revision total joint arthroplasty （TJA）. MethodsWe conducted a retrospective cohort study with a total of 2 517 patients who underwent hip or knee arthroplasties from January 2011 to January 2022 （2 394 with primary TJA， 87 with aseptic revision and 36 with PJI）. We applied univariate analysis and multivariate logistic regression to analyze differences of coagulation factors between primary TJA and aseptic revision or PJI group. Receiver operating characteristic （ROC） curve and area under the curve （AUC） were used to measure the diagnostic value of coagulation factors in predicting PJI. ResultsCoagulation factors and their ratios including plasma fibrinogen （FBG）， prothrombin time （PT）， thrombin time （TT）， activated partial thromboplastin time （APTT）， platelet （PLT）， mean platelet volume （MPV）， platelet distribution width （PDW）， plateletcrit （PCT）， PLT / MPV， PLT / PDW and PLT / PCT were included in this study. High FGB level was strongly correlated with the risk of PJI compared to other coagulation factors. The optimal threshold value of FBG was 4.53 g/L with a sensitivity of 47.22%， a specificity of 93.07% （Primary TJA group vs. PJI group）. Similarly， the optimal threshold value of FBG was 4.44 g/L with a sensitivity of 47.22%， a specificity of 95.40% between the other two groups （Aseptic revision group vs. PJI group）. ROC curve analysis demonstrated moderate diagnostic performance of FBG （AUC value）， indicating a potential to be a diagnostic marker for PJI. ConclusionsFBG is significantly correlated with PJI and it can be used as a potential non-invasive marker for early detection. It may serve as a safe and cost-effective tool for assessing PJI in clinical work.

Research progress in therapies for ischemic cerebrovascular diseases / 国际生物医学工程杂志

Ischemic cerebrovascular disease (ICVD) is the most common type of nervous system disease in clinical practice in China at present. It is the important leading cause of death after heart disease and tumors. Ischemic cerebrovascular disease has a high rate of occurrence and mortality. It is easy to cause problems such as limb dysfunction, language disorders, nerve dysfunction, etc. It has a great negative effect on the quality of life of patients, and seriously affects the quality of their lives. Although the current research on the treatment of the disease has achieved certain results, single therapies can only treat some key parts of the disease and cannot completely reverse the whole process. At present, thrombolysis, antiplatelet aggregation, degradation of plasma fibrin, anticoagulation, and hemodilution are mainly used in clinical treatment. It is critical to select appropriate treatment methods based on the pathological characteristics of patients to improve efficacy and prognosis. In this review, the research progress in therapies for ischemic cerebrovascular disease was reviewed, both at home and abroad.

Pretreatment plasma fibrinogen level as a prognostic biomarker for patients with lung cancer

Many researchers have shown that pretreatment plasma fibrinogen levels are closely correlated with the prognosis of patients with lung cancer (LC). In this study, we thus performed a meta-analysis to systematically assess the prognostic value of pretreatment plasma fibrinogen levels in LC patients. A computerized systematic search in PubMed, EMBASE, Web of Science and China National Knowledge Infrastructure (CNKI) was performed up to March 15, 2018. Studies with available data on the prognostic value of plasma fibrinogen in LC patients were eligible for inclusion. The pooled hazard ratios (HRs) and odd ratios (ORs) with 95% confidence intervals (CIs) were used to evaluate the correlation between pretreatment plasma fibrinogen levels and prognosis as well as clinicopathological characteristics. A total of 17 studies with 6,460 LC patients were included in this meta-analysis. A higher pretreatment plasma fibrinogen level was significantly associated with worse overall survival (OS) (HR: 1.57; 95% CI: 1.39-1.77; p=0.001), disease-free survival (DFS) (HR: 1.53; 95% CI: 1.33-1.76; p=0.003), and progression-free survival (PFS) (HR: 3.14; 95% CI: 2.15-4.59; p<0.001). Furthermore, our subgroup and sensitivity analyses demonstrated that the pooled HR for OS was robust and reliable. In addition, we also found that a higher fibrinogen level predicted advanced TNM stage (III-IV) (OR=2.18, 95% CI: 1.79-2.66; p<0.001) and a higher incidence of lymph node metastasis (OR=1.74, 95% CI: 1.44-2.10; p=0.02). Our study suggested that higher pretreatment plasma fibrinogen levels predict worse prognoses in LC patients.

Study of fibrinogen levels in patients of acute stroke

Background: Stroke is a disease of paramount public health significance. The role of plasma fibrinogen in determining incidence and severity of stroke has been postulated time and again. Present study was undertaken to determine the correlation between mean plasma fibrinogen level and infarct volume on CT scan in patients with acute stroke.Methods: Present prospective observational study of two years duration at our tertiary care government centre entailed enrollment and radiological assessment (CT scan/MRI) of 50 consecutive patients with first-ever stroke admitted within 24 h after stroke onset along with measurement of their plasma fibrinogen levels at admission.Results: Thirty (60%) cases reported ischemic stroke while haemorrhagic stroke was observed in 20 (40%) cases. The mean fibrinogen levels in ischemic (584±62mg/dl) and haemorrhagic stroke (52±28mg/dl) were found to be significantly higher (p<0.05) than normal range of (200-400mg/dl). The mean infarct volume in patients with ischemic stroke was 62.79±9.51cm3 while mean plasma fibrinogen level was 584±62mg/dl. There was significant correlation between infarct volume and fibrinogen levels (r coefficient =0.61; p<0.05). The fibrinogen levels in patients who died was insignificantly higher as compared to patients who survived.Conclusions: We report significantly higher than normal mean fibrinogen levels in ischemic and haemorrhagic stroke with the correlation between infarct volume and fibrinogen levels being significant in ischemic stroke. Limited mortality numbers probably didn’t allow the present study to reach the level of significance. Similar studies with larger sample size are recommended.

Current and futuristic scope of biomarkers in acute myocardial infarction

Introduction: Acute myocardial infarction is a leading cause of death throughout the world. Myocardial infarction is defined as myocardial cell death due to prolonged ischemia. Objectives of the study were to look for the role of inflammatory markers (CRP, IL-6, and plasma fibrinogen) in the prediction of myocardial infarction. In recent times, IL-6 and plasma fibrinogen are not established marker in acute myocardial infarction. However, there is another biomarker i.e. CRP that have shown additional value in improving sensitivity and prognostic information. Novel biomarkers have improved assessment of outcome in acute myocardial infarction, but none have been demonstrated to alter the outcome of a particular therapy or management strategy. Thus the finding of this study may help the clinician to develop more novel therapeutic strategies for the management of myocardial infarction (MI) patients. The outcome of the study will be very beneficial as well, to the researcher working in the concerned area in order to develop more focused research approach

Correlation of Cystatin C, Uric Acid and Fibrinogen with Lesion of Coronary Artery in Uygur Elderly Patients with Acute Coronary Syndrome / 医学研究杂志

Objective To investigate the relationship between the levels of serum cystatin C,uric acid,plasma fibrinogen and the severity of coronary lesions in Uygur elderly ACS patients in Xinjiang.Methods Retrospective analysis of 133 cases age≥65 years old Uygur patients basic information,past history,biochemical indicators which in the Xinjiang Uygur Autonomous Region People's Hospital to diagnose acute coronary syndrome and hospital coronary angiography was performed.According to the Gensini score,the patients were divided into low group (0-29 points) 44 cases,the middle group (30-59 points) 29 cases,high group (≥60 points) 60 cases,compared the cystatin C,serum Uric acid,plasma fibrinogen levels.Results With the increase of Gensini score,the levels of cystatin C,uric acid and plasma fibrinogen were increased in the Uygur elderly.Gensini scores were positively correlated with levels of cystatin C,uric acid and plasma fibrinogen (r =0.480,0.514,0.603,all P =0.000).Logistic regression analysis showed that high serum Cystatin C,uric acid,and plasma fibrinogen levels were independent risk factors for high Gensini scores.Conclusion The levels of serum cystatin C,uric acid and fibrinogen in Uygur elderly ACS patients are related to the severity of coronary artery lesion,and are the risk factors of the severity of coronary artery lesion.It is important clinical significance for the prevention of acute coronary events to detect the above indicators and to intervene early in the Uygur elderly patients with ACS.

Plasma Fibrinogen in Chronic Obstructive Pulmonary Disease – A Cross Sectional Study Conducted in a Tertiary Care Hospital in Puducherry, India.

Background: Chronic Obstructive Pulmonary Disease (COPD) is a systemic disorder rather than a respiratory disease. A significant complication that COPD can lead to a hypercoagulable state, which can lead to life-threatening diseases like Ischemic heart disease, deep vein thrombosis and Pulmonary embolism. Therefore, Fibrinogen is a useful biomarker to predict the risk of such hyper-coagulable state in COPD patients. Objectives: The study was aimed to measure the fibrinogen levels in COPD patients, to correlate the fibrinogen levels with severity of airway obstruction based on spirometry and also to compare the fibrinogen levels in COPD exacerbation patients with stable COPD individuals and healthy non-smokers. Methods: Spirometric measurement and measurement of Plasma Fibrinogen was performed on 60 patients (20 COPD patients with exacerbation; 20 stable COPD patients and 20 healthy non-smokers). Results: Raised plasma fibrinogen levels were observed in COPD patients when compared to healthy non-smokers. There was increase in the fibrinogen levels with severity of air obstruction. Among the COPD patients, raised fibrinogen levels were observed in exacerbation individuals when compared to stable COPD individuals. Conclusion: Plasma fibrinogen is a useful biomarker to monitor the disease severity in addition to the spirometric parameters in COPD patients. It gives a clue to the possibility of developing systemic complication of a hypercoagulable in COPD patients.

Effect of clopidogrel on neck blood vessel stenosis and plasma fibrinogen in patients with SIP / 中国生化药物杂志

Objective To study effect of clopidogrel on neck blood vessel stenosis and plasma fibrinogen ( FIB ) in patients with stroke in progression(SIP).Methods 80 cases with SIP were selected from March 2014 to March 2015, they were divided into study group and control group according to the random number table method, 40 cases in each group, the control group was received conventional treatment, the study group was given clopidogrel on the basis of conventional treatment, evaluation of neurological function and living ability of patients with Stroke Scale (NIHSS) and daily living ability score ( ADL) , carotid artery stenosis were measured by color Doppler, the levels of FIB and C reactive protein ( hs-CRP) in two groups were also measured, adverse reactions in the two groups were compared.Results Carotid artery, internal carotid artery, external carotid artery diameter before treatment between two groups were no statistical significance,which all increased after treatment, and the study group was wider than the control group, the difference was statistically significant (P <0.05);NIHSS score and ADL score before the treatment between two groups was no statistical significance.NIHSS score and ADL score after treatment between two groups were significant improved, and the study group was better than the control group, the difference was statistically significant (P<0.05); FIB and hs-CRP before the treatment between two groups was no statistical significance, FIB and hs-CRP levels after treatment between two groups were significantly reduced, the study group was significantly lower than the control group, the difference was statistically significant (P<0.05); the adverse reactions of the two groups were not statistically significant.Conclusion Clopidogrel can significantly improve the neurological function, improve the degree of cervical vascular stenosis, reduce the level of FIB for SIP patients in recovery period.

Correlation between levels of plasma homocysteine and fibrinogen with cerebral infarction and prognosis / 国际检验医学杂志

Objective To study the correlation between the change of plasma homocysteine (Hcy)and fibrinogen(Fib)levels with the disease condition and prognosis in the patients with cerebral infarction(CI).Methods The plasma levels of Hcy and Fib were detected in 250 cases of cerebral infarction and 100 healthy adults(normal control,NC).All patients were evaluated on 1 d af-ter admission by NHISS,and after the 6-month follow-up by the modified Rankin scale.Results The levels of plasma Hcy and Fib in the CI group were significantly higher than those in the NC group(P <0.05);the levels of plasma Hcy and Fib in the NHISS se-vere patients were higher than those in the moderate and mild patients (P <0.05);the levels of plasma Hcy and Fib in the moderate patients were significantly higher than those in the mild patients (P <0.05).The good prognosis rate the low Hcy and Fib group was significantly higher than that in high Hcy and Fib group (P <0.05).Conclusion The levels of plasma Hcy and Fib are signifi-cantly increased in the patients with CI,and the increase in the severe patients is more significant.The patients with increased plas-ma Hcy and Fib levels have relatively poor prognosis.

Assessment of Coagulation Disorder in Women Taking Oral Contraceptives.

Background: Oral contraceptive pill (OCP) is related to development of hypercoagulability and the risk of thromboembolic effects in women. Objectives: To assess the coagulability status in women taking oral contraceptives by estimation of plasma fibrinogen level and total count of platelets. Methods: This cross sectional study was conducted in the Department of Physiology, Dhaka Medical College, Dhaka, during the period of January 2012 to December 2012 on sixty apparently healthy female subjects aged 25 to 45 years taking OCPs for 1 to 10 years. Thirty subjects were 1 to 5 years user group and another 30 subjects were >5 to 10 years user group. They were collected from family planning clinics of Dhaka city. In addition, age matched 30 apparently healthy women of OCP nonusers were also studied as control. For assessment of coagulability state, plasma fibrinogen and total counts of platelet levels were estimated by automated coagulation analyzer and automated hematology analyzer. Statistical analysis was done by unpaired Student’s t’ test. Results: The mean (±SE) total count of platelet level was significantly higher (P<0.001) in contraceptive user group and plasma fibrinogen level was higher in users but it was not significant. Conclusion: This study concludes that OCP users had more tendency of hypercoagulability and therefore these women are at higher risk of thromboembolic effects.

Comparative study on different methods for detecting plasma fibrinogen by automated coagulation analyzers / 国际检验医学杂志

Objective To comparatively analyze the results of the PT derivative method and the Clauss method for detecting fi-brinogen(Fib) by the automated coagulation analyzer and to explore their accuracy and clinical value .Methods Fib was detected in 156 blood samples selected from the patients in this hospital from March to May 2013 ,25 normal control samples and 13 positive samples of D-dimer (DD) by the TP derivative method and the Clauss method .Results The Clauss method and the PT derivative method by Sysmex CA-1500 coagulation analyzer had good repetitive rate in measuring Fib for 25 times ;when Fib0 .05);when Fib in the range of 4 .1 -5 .0 g/L ,the detection results had statistically significant difference (P5 .0 g/L ,the detection results had statistically significant difference (P<0 .05);in 13 DD positive samples ,the detection results of the PT derivative method were significantly higher than those of the Clauss method with statistically significant difference (t=8 .530 , P<0 .05) .Conclusion The difference exists between the PT derivative method and the Clauss method for detecting Fib ,but the ac-curacy of the Clauss method is higher than its specificity ,the Clauss method should be the first choice for the clinical determination of plasma Fib .

Changes of plasma fibrinogen and D-dimer in patients with lung cancer and the influence of interventional therapy / 实用放射学杂志

Objective To explore the clinical significance of plasma fibrinogen(FIB)and plasma D-dimer (D-D)changes involved in lung cancer patients before and after interventional therapy.Methods 23 patients with lung cancer,27 cases of normal control group collected at the same time,to compared the difference of plasma FIB between patients with lung cancer and the normal control group.All enrolled patients were treated with bronchial artery infusion chemotherapy.Plasma FIB and D-D of all patients were meas-ured before the first and the third interventional therapy.Results Plasma FIB value of patients before interventional therapy was sig-nificantly higher than that of the normal control group and the group after interventional therapy.The difference between the group after interventional therapy and the normal control group was no significant;Plasma D-D value of patients before and after interven-tional therapy was significant.Conclusion Changes of plasma FIB and D-D before and after interventional therapy in patients with lung cancer are significantly correlated with the severity of the disease and interventional therapy efficacy,which can be used as a ver-y meaningful indicator of interventional therapy.

Correlation of plasma fibrinogen and lipoproteins in diabetic hypertensive patients .

Background: Diabetic hypertensive patients have higher cardiovascular morbidity and mortality than general population. Various risk factors like age, BMI (Body mass index), hypertension, smoking, dyslipidemia, etc. have been extensively studied, but still these together cannot explain increased cardiovascular morbidity and mortality in diabetes. Several studies have shown that fibrinogen is a powerful independent risk factor for cardiovascular disease. Hence fibrinogen levels and its correlation to lipoproteins in diabetic hypertensives were studied. Objective: To estimate plasma fibrinogen levels in patients with type 2 diabetes mellitus and hypertension and to correlate plasma fibrinogen with Lipoproteins and also with BMI. Materials and Methods: A Prospective cross sectional study conducted in a tertiary care hospital. Data collected by simple random sampling method and analysis of various parameters done by using chi square-test and correlated with pearson’s correlation coefficient “r”. Results: The higher plasma fibrinogen levels were found in diabetic hypertensives (449.06 ± 131.26) when compared to controls. The mean total cholesterol, TG (triglycerides), LDL (Low density lipoprotein), VLDL (Very low density lipoprotein), HDL (High density lipoprotein) among cases were 195.82 ± 26.92 mg/dl, 243.62 ± 45.83 mg/dl, 104.15 ± 25.76 mg/dl, 48.72 ± 9.17 mg/dl, 38.21 ± 4.03 mg/dl respectively and the mean BMI of cases was 26.16 ± 5.36 kg/m2. The plasma fibrinogen is positively correlated to BMI and total cholesterol levels which is statistically significant. Conclusion: The plasma fibrinogen levels could potentially be considered for screening programs to identify people at high risk of vascular events.

Von Willebrand factor research on related factor of coagulation abnormalities in type 2 diabetic nephropathy / 中国综合临床

Objective To study the early changes of the coagulation system in type 2 diabetic nephropathy.Methods Sixty-two cases of patients with type 2 diabetic nephropathy were divided into two groups:normal albuminuria group ( N-UAlb group,UACR ＜ 30 mg/g,32 cases ),microalbuminuria group ( MUAlb group,UACR:30～300 mg/g,30 cases).Thirty healthy persons constituted a control group (NC group).Fibrinogen( FIB ),antithrombin Ⅲ ( AT-Ⅲ ),protein C ( PC ),protein S ( PS ) were measured by coagulation analyzer,while yon willebrand factor (vWF) and platelet granule membrane protein 140 (GMP-140) were detected by ELISA assay,platelet count (PLT),mean platelet volume(MPV),platelet hematocrit (PCT),platelet distribution width(PDW) by hematology analyzer.Results The level of fibrinogen,GMP-140 and vWF in the M-UAlb group were (4.20 ± 1.53 ) g/L,( 30.03 ± 7.77 ) μg/L,and ( 315.53 ± 47.24 ) ％ respectively,vwhich were significantly higher than those in the N-UAlb group [ ( 3.21 ± 0.89 ) g/L,( 18.22 ± 5.08 ) μg,/L and ( 191.88 ± 57.25 ) ％ respectively ] and the NC group [ ( 2.75 ± 0.53 ) g/L,( 14.26 ± 2.29 ) μg/L and ( 138.12 ± 61.27 ) ％ respectively ] ( F =5.42,10.42,30.44,P ＜ 0.05 or 0.01 ).The fibrinogen,vWF,GMP-140 were positively correlated with UACR ( r =0.313,P ＜ 0.05 ; r =0.620,P ＜ 0.01 ; r =0.680,P ＜ 0.01 ) and PC was negatively correlated with UACR ( r =-0.255,P ＜ 0.05 ).Conclusion Hypercoagulable state in diabetic nephropathy is associated with the high fibrinogen,endothelial dysfunction and platelet activation,and these changes have already emerged in patients without albuminuria.This might mind us that we should strengthen anticoagulant therapy on patients when they are not progressing to albuminuria.

A Cross-sectional Study on the Relationship between Plasma Fibrinogen Level and the Peripheral Arterial Occlusive Disease / 中国慢性病预防与控制

Objective To examine the relationship between the levels of plasma fibrinogen and the Peripheral Arterial Occlusive Disease(PAOD)in an elderly population.Methods A population-based cross-sectional study was conducted in an urban Beijing sample of 2 680 subjects aged 60 years or older.Plasma fibrinogen was measured by the means of dispersion and comparing turbidity.PAOD was assessed by symptoms of intermittent claudication(IC)as measured by the WHO/ROSE questionnaire and an ankle-arm systolic blood pressure index(AAI)(