RESUMEN
Objective:To explore the effects of Jianpi Huaji Fuzheng Decoction supplemented with conventional chemotherapy on Traditional Chinese Medicine (TCM) syndromes scores, cellular immunity and coagulation-fibrinolysis function in patients with primary hepatic carcinoma of spleen-deficiency syndrome.Methods:Prospective cohort study. A total of 85 patients with primary hepatic carcinoma of spleen-deficiency syndrome who met the inclusion criteria in the hospital between March 2018 and March 2021 were divided into 42 cases in control group and 43 cases in observation group according to the random number table method. The control group was given conventional western medicine chemotherapy, and the observation group was given Jianpi Huaji Fuzheng Decoction on the basis of the control group. Both groups were treated for 3 months. Before and after treatment, the TCM syndromes were scored. The levels of CD4 + and CD8 + were detected by flow cytometry with indirect immunofluorescence, and the ratio of CD4 +/CD8 + was calculated. The plasma prothrombin time (PT), fibrinogen (Fg) and coagulation factor Ⅶ (CFⅦ) were detected by automatic blood coagulation analyzer. The toxic and side effects of chemotherapy during treatment were recorded and the clinical efficacy was evaluated. Results:The total effective rate of syndrome efficacy was 95.35% (41/43) in observation group and 78.57% (33/42) in control group ( χ2=3.92, P=0.047). After treatment, the scores of flank pain, lumps, fatigue and jaundice and total score in observation group were significantly lower than those in the control group ( t=2.60, 2.64, 2.85, 2.91, 3.79, P<0.01). The level of CD4 + [(37.68±3.72)% vs. (35.92±3.61)%, t=2.21] and CD4 +/CD8 + [(1.44±0.22) vs. (1.31±0.23), t=2.66] in observation group were significantly higher than those in the control group ( P<0.05), while the level of CD8 + [(26.20±2.72)% vs. (27.44±2.16)%, t=2.32] was significantly lower than that of the control group ( P<0.05). The levels of Fg [(3.11±0.85) g/L vs. (2.74±0.72) g/L, t=2.16] and CFⅦ [(1.76±0.44) mg/L vs. (1.58±0.37) mg/L, t=2.04] were significantly higher than those in the control group ( P<0.05). PT [(14.65±2.72) s vs. (15.91±3.03) s, t=2.02] was significantly shorter than that of the control group ( P<0.05). During treatment, the incidence rate of toxic and side effects of chemotherapy was 11.63% (5/43) in observation group and that in control group was 30.95% (13/42) ( χ2=4.75, P=0.029). Conclusion:Jianpi Huaji Fuzheng Decoction supplemented with conventional chemotherapy can improve the clinical symptoms, promote the recovery of cellular immune function and coagulation-fibrinolysis function, reduce the incidence rates of toxic and side effects of chemotherapy, and enhance the clinical efficacy of patients with primary hepatic carcinoma.
RESUMEN
Objective To observe the influences of infusion with normal saline (NS), Ringer solution and hydroxyethyl starch 130/0.4 sodium chloride on blood coagulation/fibrinolysis in rabbits with acute respiratory distress syndrome (ARDS) induced by two-hit of oleic acid (OA) and lipopolysaccharide (LPS).Methods According to random number table, 40 healthy adult male rabbits were divided into sham operation, model, NS, Ringer and colloid groups (8 rabbits in each group). The ARDS model was replicated by sequential injection of OA (0.1 mL/kg) and LPS (500μg/kg) into the ear marginal vein of rabbit. Immediately after injection of LPS, the NS, Ringer and colloid groups were treated by intravenous infusion of NS, lactate Ringer solution and hydroxyethyl starch 130/0.4 sodium chloride, respectively at a speed of 7 mL·kg-1·h-1 for 210 minutes. There was no liquid infusion in model and sham operation groups. At 30 minutes and 210 minutes after LPS injection, the arterial blood was collected and the partial pressure of arterial blood oxygen (PaO2) was measured and the oxygenation index (PaO2/FiO2) was calculated. At 5, 30, 120 and 210 minutes after LPS injection, venous blood was collected, and activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen (Fib), antithrombase Ⅲ (AT-Ⅲ), serum procollagen peptide Ⅲ (PⅢP), tissue plasminogen activator (t-PA) were measured, respectively. After the rabbits were killed by bloodletting at the end of experiment, the lung tissues were obtained, collagen Ⅰ and collagen Ⅲ in lung tissues were detected by immunohistochemistry staining, lung wet/dry weight ratio (W/D) and pathologic score of lung tissues were calculated.Results Compared with sham operation group, at 30 minutes and 210 minutes in model group the levels of PaO2/FiO2 were significantly decreased, and the lung W/D ratios as well as pathologic scores of pulmonary tissues were increased. In model group, the APTT began from 30 minutes while the PT began from 120 minutes to gradually prolong, and the value of Fib was progressively decreased; with a tendency of mild decline, the levels of AT-Ⅲ at all time-points were lower in model group than those in sham operation group (allP < 0.05). The levels of t-PA and PⅢP at all time-points were significantly higher, and the expression levels of collagen Ⅰ and collagen Ⅲ in model group were obviously more strengthened compared to those in sham operation group. Among the three infusion groups, the improvement degrees of PaO2/FiO2, lung W/D ratio and pathologic score of pulmonary tissues were the highest in NS group, lowest in colloid group, and no significant changes in Ringer group. APTT in NS group except 120 minutes was longer, the APTTs at 30 minutes and 210 minutes were shorter in NS group than those in model group (s: 30 minutes: 52.26±18.65 vs. 76.22±16.64, 120 minutes: 90.60±10.66 vs. 83.01±15.88, 210 minutes: 70.44±17.80 vs. 77.04±13.32, allP < 0.05); the prolongation of amplitudes of APTT in Ringer and colloid groups were greater than that in model group, particularly in colloid group, the greatest; the PT in three infusion groups were gradually prolonged, and at 120 minutes and 210 minutes were all longer than that in model group (allP < 0.05). The levels of Fib in those treatment groups were all gradually decreased, the amplitude descent of Fib in NS group was the smallest and that in colloid group, the biggest; the levels of AT-Ⅲ in three infusion groups and model group had similar decline tendency, the descending amplitude being the most significant in colloid group. The levels of t-PA at all time-points in the three treatment groups were lower than those in model group (allP < 0.05). The levels of PⅢP in serum at all time-points were lower in Ringer and NS groups than those in model group (μg/L: Ringer group: 5 minutes: 250.60±36.53 vs. 285.77±65.55, 30 minutes: 248.73±44.41 vs. 302.16±37.73, 120 minutes: 249.14±43.16 vs. 296.09±38.64, 210 minutes: 246.62±44.72 vs. 295.45±42.75; NS group: 5 minutes: 261.89±50.74 vs. 285.77±65.55, 30 minutes: 247.71±50.40 vs. 302.16±37.73, 120 minutes: 246.58±42.27 vs. 296.09±38.64, 210 minutes: 222.73±18.51 vs. 295.45±42.75, allP < 0.05), but there were no statistically significant differences between the colloid group and model group. The expression levels of collagen Ⅰ and collagen Ⅲ in all liquid infusion groups were lower than those in model group (P < 0.05 orP < 0.01), whereas in colloid group were higher than those in NS and Ringer groups (allP < 0.05).Conclusions The infusion of NS, lactate Ringer solution and hydroxyethyl starch 130/0.4 sodium chloride have different influences on the blood coagulation function in ARDS rabbits, among which the effect of NS is the least, while of the hydroxyethyl starch 130/0.4 sodium chloride appears the greatest. The infusion of these three liquids can all decrease the pulmonary fibrous tissue in rabbits with ARDS, and in the mean time can alleviate the lung tissue pathological lesion for a certain degree, the effect of NS and Ringer solution being greater than that of hydroxyethyl starch 130/0.4 sodium chloride.
RESUMEN
Objective To detect the levels of plasma gelsolin(GSN),vitamin D binding protein(VDBP)and coagulation?related parameters in peripheral blood between pre?eclampsia,then analyze their relationships with the onset or development of pre?eclampsia. Methods A total of 30 women with severe pre?eclampsia(SPE)and 30 women with mild pre?eclampsia(MPE)were enrolled for the study and randomly chosen as trial group. 30 normal pregnancies with matching gestational ages were selected as control group?1 and 30 normal full?term pregnancies were randomly chosen as control group?2. The levels of GSN,VDBP,platelet(PLT),prothrombin time(PT),thrombin time(TT),activated partial thromboplas?tin time(APTT),fibrinogen(FIB),and D?dimer were compared between those groups. Results The levels of GSN,VDBP and PLT,PT,APTT, FIB in SPE group were significantly lower than that of MPE group(P0.05). There were no statistical difference among all the levels of coagulation?related parameters in healthy pregnant women(P>0.05). Conclusion GSN and VDBP levels in pre?eclampsia are significantly lower than that of normal pregnant women,along with pathological hy?percoagulative state,and which are related to severity of disease.
RESUMEN
This article was aimed to study macroporous resin adsorption kinetics for effective extraction of water ex-tracting with alcohol precipitating in cicada slough. PT, APTT and the coagulation-fibrinolysis dynamic figure were taken as main indexes, which were combined with static and dynamic tests, to select the best macroporous resin to separate and purify the extraction. Adsorption kinetics curve was drawn to fit the adsorption kinetics model. The re-sults showed that NKA-9 macroporous resin was more effective in separating and purifying effective extraction than others. The adsorption dynamic behavior was well described by the pseudo-second-order kinetics equation. It was concluded that the adsorption rate was mainly controlled by the intraparticle diffusion.
RESUMEN
Pulmonary fibrosis is a common respiratory disease in the clinic. Until now, the pathogenesis is still un-clear. Using clotting mechanism as the starting point, this article mainly explored abnormal changes of the coagula-tion - fibrinolysis system in the development of pulmonary fibrosis. The effective treatment through the activation of blood circulation to remove stasis in traditional Chinese medicine (TCM) point of view was also observed on the man-agement of interstitial pulmonary fibrosis. It considered that to carry out the anticoagulant therapy for abnormal coag-ulation, which may become a new target for clinical treatment of interstitial lung diseases. It provided new ideas and theoretical support for clinical treatment of pulmonary interstitial fibrosis.
RESUMEN
Patients with chronic type B aortic dissection usually require surgical repair due to aortic dissection-related complications, whereas those with uncomplicated type B acute aortic dissection can usually be managed with medical therapy. Disseminated intravascular coagulopathy (DIC), as well as aortic enlargement, visceral or limb ischemia and recurrent dissection, has been reported as one of the rare complications of type B aortic dissection which require surgical treatment in the chronic phase. DIC is a severe complication which can result in catastrophic events such as gastrointestinal and cerebral bleeding. The management of DIC as a complication of chronic aortic dissection is still controversial, as medical treatment involving anticoagulants and the supplementation of coagulation factors via a transfusion of fresh frozen plasma is not completely reliable. Surgical treatment to close a false lumen can be corrective, but carries the risk of excessive bleeding due to DIC. We report a patient with chronic type B dissection with a patent false lumen complicated by overt DIC. This patient had frequent occurrences of purpura on the upper and lower extremities. Contrast computed tomography in the late phase showed stagnation of contrast medium in the thoracic false lumen, which strongly idicated this false lumen to be the origin of the DIC. We gave the patient a continuous drip infusion of heparin (12,000 U/day) for 1 week before the operation, after which we performed total aortic replacement in order to thrombose the false lumen. His coagulation profile, including platelet count, prothrombin time, international normalized ratio and clinical symptoms improved immediately after the operation. Computed tomography (CT) performed 3 months after the operation showed complete thrombosis and obstruction of the false lumen in the thoracic aorta. The patient is currently well and has resumed routine activities. The continuous infusion of heparin for 1 week was highly effective to improve the coagulopathy in the present case. This case underscores the importance of conducting follow-up to evaluate coagulation-fibrinolysis system function and to measure the aortic diameter by CT in patients with chronic type B aortic dissection with a patent false lumen. Comparison of the early and late phases of contrast-enhanced CT was extremely useful to determine the cause of coagulopathy in this case. Furthermore, the coagulopathy was successfully treated by total aortic arch replacement to close the entry of the false lumen.
RESUMEN
Objective To study the relation between coagulation-fibrinolysis and metastasis, hormone receptor and TNM stage of breast cancer. Methods The plasm levels of six coagulation-fibrinolysis indexes of 30 breast cancer patients were tested, which included activated partial thromboplastin time(APTT), fibrinogen(FIB), D-dimer(D-Di), tissue type plasminogen activator (t-PA)and plasminogen activator inhibitor-1(PAI-1). Statistic analysis of the relation between the changes of these indexes and metastasis, hormone receptor and breast cancer cell proliferation was performed. Results There were statistically significant differences between the malignant and benign breast disease in FiB(3.05±0.44)g/L vs(3.39±0.52)g/L(P＜0.05),D-Di(0.27±0.06)μg/ml vs(0.36±0.16)μg/ml(P＜0.05) and PAI-1(26.14±3.30)ng/ml vs(34.59±3.68)ng/ml (P＜0.01). The levels of plasma FIB (3.70±0.47)g/L and PAI-1 (37.36±2.71)ng/ml in metastasis group were higher than those in the non-metastasis group (P＜0.01). Significantly higher levels of PAI-1(36.40±3.57)ng/ml(P＜0.05)in expression of Ki67≥30% in the patients with lymph node involvement were seen. Conclusion Coagulation-fibrinolysis indexes were related to the proliferation, invasion, metastasis and clinical stage of breast cancer and it can serve as an important marker for predicting breast cancer's biological behavior and prognosis.
RESUMEN
Background and objective The value of D-dimer in the risk stratification of patients with coronary artery diseas(CAD)and the relationship between D-dimer and the diseased coronary arteries remains controversial or unclear.especially in the elderly.Thisstudy was to evaluate the usefulness of D-djmer as a biomarker in assessing the vuinerable blood in the elderly patients with coronarydisease.Methods Sixty elderly (≥60 years old)male patients with suspected CAD were enrolled in this prospective study.Patients were divided into CAD group(n=41,10 with stable angina and 31 with unstable angina)and control group(n=19)according to their coronary angiography Results Clinicalinformation including age,body mass index(BMI),smoking index,and thecomplications of Primary hypertension or diabetes.and CAD family history was collected.Venous blood was sampled serially for thedetermination of total cholesterol,HDL cholesterol,LDL cholesterol,triglycerides,apoAl,apoB,glucose,uric acid,homocysteine(Hey),hs-CRP,soluble thrombomodulin(sTM),and marker of fibrinolytic system and hypercoagulability,such as D-dimer,fibrinogen,etc.The extent of coronary atherosclerosis was assessed.using the Gensini scoring system on the basis of coronary angiography.Results Compared with the controls.the patients with CAD had significantly higher levels of D-dimer.D-dimer level wassignificantly correlated to age.hs-CR P.Hcy,and PAI-1.Patients with D-dimer levels in the top triplicate of D-dimer level hadsignificantly higher prevalence of unstable angina compared with patients in the lowest triplicate(OR=4.8,Z=3.28,P=0.001).In anordinal logistic regression.the OR value ofdeveloping more serious CAD augmented 3.1-foid with each increasing triplicate of D-dimer.Patients with unstable angina had a significantly higher level of D-dimer than the controls(P=0.005),and an increasing trend comparedwith patients with stable angina (P=0.059).whereas there was no difference between the patients with stable angina and the controls(P=0.885).D-dimer was significantly correlated with Gensini scores(r=0.3930,P=0.0019).Ordinal logistic regression showed that theOR value ofincreasing one or two triplicates of Gensini's scores augmented 1.44.fold with each increasing triplicate of D-dimer(OR=2.44,Z=2.87,P=0.004). Conclusions D-dimer may be a helpful biomarker in identifying the severity of vulnerable blood in elderlypatients with CAD.
RESUMEN
Objective To find out the changes of endothelial cell function and coagulation-fibrinolysis system in maintenance hemodialysis(MHD)patients with diabetic nephropathy(DN).Methods The plasma levels of TM,PAI-1,TAT and PAP in 28 DN-MHD,34 non-DN MHD and 40 controls were measured by ELISA.Results (1)The levels of TM,PAI-1,TAT and PAP in both DN group and non-DN group were significantly higher than those in control group,P
RESUMEN
We studied intraoperative changes of transurethral resection of the prostate in blood coagulation-fibrinolysis system by thromboelastography (TEG) in 31 patients with benign prostatic hyperplasia. As TEG parameters reaction time (R), clot formation time (K), maximum amplitude (MA), coagulation time (R+K), clot lysis index after 60 minutes (Ly60) were measured. The coagulability was evaluated by R and R+K, the absolute strength of clot by MA, and fibrinolysis by Ly60. Coagulation time (R+K) was shortened in patients with decreased platelet count under 30,000 u/L (p<0.05), irrigating fluid volume over 20,000 ml (p<0.05) and had a tendency of shortening in patient with resection time over 50minutes (p=0.078). MA had a tendency of increasing but significant contributing factor was not detected. The mean value of Ly60 was increased significantly but the change was in normal range. Irrigating fluid volume (r=-0.407, p<0.05) and resection time (r=-0.456, p<0.05) showed negative correlation significantly with the change of R + K. There was no significant correlation between resected prostatic weight and TEG parameters. We concluded that coagulability is increased during TURP suggesting a possible role in postoperative clot retention, but the risk of fibrinolysis is not increased in patients with normal coagulation-fibrinolysis system.
Asunto(s)
Humanos , Fibrinólisis , Recuento de Plaquetas , Próstata , Hiperplasia Prostática , Tiempo de Reacción , Valores de Referencia , Tromboelastografía , Resección Transuretral de la PróstataRESUMEN
Objective: To observe the balance of modified coagulation and fibrinolysis in patients undergoing open heart surgery with cardiopulmonary bypass (CBP). Method: The balance of modified coagulation-fibrinolysis in 20 cases were measured by coagulation-fibrinolysis dynamicography instrument (FD-Ⅲ) at the pre-CPB, post-CPB, 24, 48 and 168 hours postoperatively. Result: At the post-CPB, coagulation starting time(CST), maximum coagulation time (MCT), whole time of fibrinolysis reaction (WFT) and balance time (BLT) were significantly more than at pre-CPB (P