Isquemia aguda por trombosis aórtica en COVID-19: A propósito de un caso

Objetivo: Presentar un caso de isquemia aguda por trombosis aórtica en paciente con infección por COVID-19 y exponer la importancia del diagnóstico y manejo oportuno. Introducción: El coronavirus (COVID-19) afecta principalmente al tracto respiratorio, pero presenta predisposición a fenómenos trombóticos y sus complicaciones, siendo una de las más graves la isquemia aguda por trombosis aórtica. Caso clínico: Paciente masculino de 68 años, que cursa con cuadro clínico de neumonía grave por COVID-19, presenta de forma concomitante episodio de trombosis aórtica aguda, resultando con isquemia aguda de extremidades inferiores. Se realizó trombectomía, post procedimiento y asociado a reperfusión, presentó paro cardiorrespiratorio con asistolia sostenida, falleciendo pese a maniobras de reanimación. Conclusión: Pese a las medidas de profilaxis con heparina de bajo peso molecular (HBPM), se deben sospechar y buscar las complicaciones tromboembólicas en pacientes que cursan con esta infección para dar un manejo oportuno y vigilar las complicaciones post quirúrgicas que pueden ser mortales.

Aim: To present a case of acute ischemia due to aortic thrombosis in a patient with COVID-19 infection and explain the importance of diagnosis and timely management. Introduction: The coronavirus (COVID-19) mainly affects the respiratory tract, but it has a predisposition to thrombotic phenomena and its complications, one of the most serious being acute ischemia due to aortic thrombosis. Clinical case: 68-year-old man, coronary heart disease with severe pneumonia due to COVID-19, presents aortic thrombosis, resulting in acute lower extremity ischemia. Thrombectomy was performed, post procedure and associated with reperfusion, presented cardiorespiratory arrest with sustained asystole, died despite resuscitation maneuvers. Conclusion: Despite prophylaxis measures with low molecular-weight heparins (LMWH), thromboembolic complications should be sought in patients with this infection to provide timely management and monitor post-surgical complications that can be fatal.

Early thrombotic risks and prophylactic anticoagulation after liver transplantation / 中华器官移植杂志

In early stage after liver transplantation(LT), coagulation function of recipients stays in a fragile balance. Affected by a variety of complex mechanisms, blood is usually hypercoagulable. An imbalance between coagulation factors and physiological anticoagulants, elevated level of vWF, an occurrence of fibrinolysis inhibition and dosing of immunosuppressive agents cause a hypercoagulable state in an early stage after LT. Blood hypercoagulability may lead to such thrombotic complications as hepatic artery, portal vein and deep vein thromboses. Some studies have demonstrated that postoperative prophylactic anticoagulation has some effect in reducing the risks of early postoperative thrombosis. However, there is still a great lack of high-quality evidence. This review summarized the latest researches on early coagulation dysfunction, thrombosis and preventive anticoagulation after LT.

COVID 19 INFECTION IN A PATIENT NEWLY DIAGNOSED WITH HIV/TB COINFECTION – A CASE REPORT

HIV/TB coinfection, COVID 19 with HIV/TB, immune reconstitution inflammatory syndrome (IRIS), TB lymphadenopathy

A case of acute carbon monoxide poisoning with secondary intestinal obstruction and thrombosis / 中华劳动卫生职业病杂志

Acute carbon monoxide poisoning can cause multiple organ damage due to hypoxia. In severe cases, it can be life-threatening and has a high fatality rate. Intestinal obstruction and thrombosis are rare complications of carbon monoxide poisoning. A case of carbon monoxide poisoning was reported. In addition to the central nervous system lesion, intestinal obstruction and lower limb thrombosis were also found. In the treatment of carbon monoxide poisoning patients, the clinician was able to treat the common complications, attention should be paid to gastrointestinal tract, thrombotic disease and other rare complications, so as to avoid missed diagnosis.

Effect of moxibustion on renal function and hypercoagulable state in patients with idiopathic membranous nephropathy of low to medium risk with spleen-kidney deficiency and blood stasis / 中国针灸

OBJECTIVE@#To compare the effect of moxibustion combined with basic treatment and simple basic treatment on the clinical symptoms, renal function and hypercoagulable state in patients with idiopathic membranous nephropathy (IMN) of low to medium risk with spleen-kidney deficiency and blood stasis.@*METHODS@#A total of 60 patients with IMN of low to medium risk with spleen-kidney deficiency and blood stasis were randomized into an observation group (30 cases, 2 cases dropped off) and a control group (30 cases, 1 case dropped off). In the control group, the conventional basic treatment of anti-hypertension, regulating blood lipid and anti-coagulation was adopted. On the basis of the control group, moxibustion was applied at Shenshu (BL 23), Pishu (BL 20), Guanyuan (CV 4), Zusanli (ST 36) and Sanyinjiao (SP 6) in the observation group, once a day, 5 days a week continuously with 2 day interval. The treatment of 6 months was required in the both groups. Before treatment and 3 and 6 months into treatment, the total TCM syndrome score, the renal function indexes (24-hour urinary protein quantity [UTP], albumin [ALB], urea nitrogen [BUN] and creatinine [Scr]), the blood coagulation indexes (fibrinogen [FIB], D-Dimer [D-D], p-selection and von Willebrand factor [vWF]), total cholesterol (TC) and triacylglycerol (TG) levels were observed, and the therapeutic efficacy was evaluated on 3 and 6 months into treatment in the two groups.@*RESULTS@#The effective rates of 3 and 6 months into treatment were 78.6% (22/28) and 89.3% (25/28) in the observation group, which were higher than 62.1% (18/29) and 75.9% (22/29) in the control group respectively (@*CONCLUSION@#Moxibustion combined with basic treatment can effectively improve the clinical symptoms, renal function and renal microcirculation in patients with idiopathic membranous nephropathy of low to medium risk with spleen-kidney deficiency and blood stasis, the therapeutic effect is superior to the simple basic treatment.

An Uncommon Cause of Leg Swelling After Exercise: A Case Report on An Unprovoked Deep Vein Thrombosis in Young Healthy Man

@#Antiphospholipid syndrome is a hypercoagulable autoimmune condition that predominantly affect the female and commonly manifest as arterio-venous thrombosis and recurrent miscarriage. Here, we present a unique case of a healthy young man who developed sudden onset of right leg swelling after exercise which was then found to be due to deep vein thrombosis via Doppler ultrasound. His blood investigations showed thrombocytopenia and prolonged coagulation profile. Therefore, antiphospholipid syndrome was suspected and later confirmed by positive autoimmune antibodies. He was treated with long term moderate intensity oral warfarin. The objective of this case report is to share the uncommon occurrence of an unprovoked deep vein thrombosis secondary to antiphospholipid syndrome in a healthy young man so that the possibility of deep vein thrombosis should be suspected in selected cases of non-resolving leg swelling after exercise as it can lead to fatal pulmonary embolism.

Perioperative Venous Thromboembolism (VTE) Prophylaxis in Thoracic Cancer Patients: Chinese Experts Consensus - Interpretation of Perioperative Hypercoagulable State / 中国肺癌杂志

Venous thromboembolism (VTE) is a common perioperative complication of lung cancer and a major cause of unexpected death in hospital. The clinical risk factors of VTE include: patients' factors (advanced age, obesity, etc.), tumor-related factors (classification, staging, etc.), treatment-related factors (chemotherapy, surgery, etc.). In addition, tumor cells express cancer procoagulant (CP), tissue factor (TF), inflammatory factors or activate platelets, inflammatory cells and other related cells, directly or indirectly activate the coagulation process, and cause blood hypercoagulable state, thus promote the occurrence of VTE. At the same time, the relevant biomarkers can also reflect the perioperative coagulation status of patients, which is helpful to more accurately identify high-risk subgroups to establish more accurate and targeted anticoagulation strategies to prevent thrombosis in lung cancer patients.

Influence of Shengmaiyin Combined with Xuefu Zhuyu Tang on Hypercoagulable State Caused by Non-small Cell Lung Cancer / 中国实验方剂学杂志

Objective:To observe influence of dialectical addition and subtraction of Shengmaiyin combined with Xuefu Zhuyu Tang on fibrinolytic activity and coagulation active factor of patients with non-small cell lung cancer at hypercoagulable state. Method:One hundred and eighty patients were randomly divided into control group (58 cases) and observation group (60 cases) by random number table. Patients in control group got low molecular weight heparins calcium injection by subcutaneous injection for 3 weeks, 1.0 mL (5 000 AXa unit)/time, 1 time/day, and oral aspirin enteric-coated tablets, 100 mg/time, 1 time/day. Patients in observation group got dialectical addition and subtraction of Shengmaiyin combined with Xuefu Zhuyu Tang, 1 dose/day. A course of treatment was 8 weeks. And activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), platelet (PLT), fibrinogen (FIB), D-dimer (D-D), plasma tissue plasminogen activator (t-PA), plasminogen activator inhibitor in plasma-1 (PAI-1), von willebrand factor (vWF), P-selectin, basic fibroblast growth factor (bFGF), transforming growth factor (TGF), vascular endothelial growth factor (VEGF) were detected. And before and after treatment, scores of Qi deficiency and blood stasis syndrome and hemorheological indices were detected. Result:After treatment, APTT, PT and TT in observation group were longer than those in control group. Levels of PLT, D-D and PAI-1 were lower than those in control group (PPPPPPPConclusion:Dialectical addition and subtraction of Shengmaiyin combined with Xuefu Zhuyu Tang can ameliorate hypercoagulable state of NSCLC, relieve clinical symptoms, and can regulate fibrinolytic activity and coagulation activity factors, so it can mitigate dangers caused by deep venous thrombosis of NSCLC.

Expression and clinical significance of coagulation factorⅢin non-small cell lung can-cer patients with hypercoagulability / 中国肿瘤临床

Objective:To study the expression of coagulation factorⅢin patients with non-small cell lung cancer(NSCLC)with hyperco-agulability and its clinical significance,and to explore the relationship between its expression level and the clinicopathological features and the survival period.Methods:There were 74 patients with NSCLC with hypercoagulability and 42 without hypercoagulability,con-firmed using pathological and biochemical tests in Yunnan Cancer Hospital from January 2013 to October 2014.The enzyme-linked im-munosorbent assay(ELISA)was performed to detect the expression of serum coagulation factorⅢand its relationship with clinico-pathological features and prognosis was analyzed.Results:Serum coagulation factorⅢlevel in patients with hypercoagulable NSCLC before chemotherapy was 560.32-200.34 ng/L,which was significantly higher than that in patients without hypercoagulability(463.29-159.22 ng/L)(P=0.008),and significantly higher than that in patients after chemotherapy(471.39±160.31 ng/L)(P=0.000).Serum coag-ulation factorⅢlevel in patients with hypercoagulable state of NSCLC was related to lymph node metastasis(P=0.026),distant metas-tasis(P=0.025),and tumor-node-metastasis staging(P=0.007).They were negatively correlated with prothrombin time(r=?0.638,P=0.032)and activated partial thromboplastin time(r=?0.702,P=0.028),and positively correlated with fibrinogen(r=0.715,P=0.008)and platelets (r=0.597,P=0.007).The 1-to 3-year overall survival of patients with NSCLC with high coagulation factorⅢexpression was significantly lower than that of patients with low coagulation factorⅢexpression.Conclusions: The expression level of serum coagu-lation factorⅢin patients with high coagulation state of NSCLC is related to lymph node metastasis and TNM staging,which has cer-tain guiding significance for predicting the survival of patients.

Research progress of relationship between pancreatic cancer and blood coagulation factors / 复旦学报（医学版）

It has been widely considered that the pancreatic cancer has an inherent and unique ability to induce a hypercoagulable state that leads to clinically significant thrombosis.During examination of lower-limb venous with color doppler blood flow images,more than 50％ of pancreatic cancer patients were found having deep vein thrombosis (DVT).The causes of the hypercoagulable state in pancreatic cancerare still partly understood now.Its relationship with invasion,metastasis and prognosis of pancreatic cancer also need further research.How to deal with this kind of hypercoagulable state is worthy of study.This article discusses changes of some main factors in clotting mechanism of pancreatic cancer.The progress of research on the prevention and treatment is expounded and the future research direction is also put forward.

Value of neutrophil lymphocyte ratio and coagulation parameters for diagnosing hypercoagulable state in patients with malignant tumor / 国际检验医学杂志

Objective To investigate the clinical value of neutrophil lymphocyte ratio(NLR)and coagula-tion parameters for diagnosing hypercoagulable state in the patients with malignant tumor.Methods A total of 683 cases of malignant tumor and 200 cases of benign tumor in this hospital from December 2014 to Decem-ber 2016 were selected as the malignant tumor group and benign tumor group respectively.The malignant tumor group was further divided into the hypercoagulability group and non hypercoagulable group according to the combination of hypercoagulability.Meanwhile 143 individuals undergoing healthy physical examination were selected as the control group.The changes of neutrophil count(NC),lymphocyte count(LC),NLR,D-dinner,fibrinogen(Fib),platelet count(PLT)and platelet distribution width(PDW)were observed.The sen-sitivity and specificity of NLR and coagulation parameters for diagnosing hypercoagulable state were analyzed. Results The NC level and NLR in the malignant tumor group were higher than those in the benign tumor group and control group,while the LC level was lower than that in the benign tumor group and control group, the difference was statistically significant(P< 0.05).The D-D,Fib and PDW levels in the malignant tumor group were higher than those in the benign tumor group and control group,while the PLT level was lower than that in the benign tumor group and control group,the difference was statistically significant(P<0.05).

Coagulation index and ALC in children with lymphoma before and after chemotherapy changes and its clinical significance / 国际检验医学杂志

Objective To explore the changes of coagulation index and absolute neutrophil count(ANC) before and after chemotherapy in lymphoma and its clinical significance.Methods 80 cases of lymphoma chil-dren admitted in our hospital from February 2013 to February 2016 were selected as the observation group,In addition,50 healthy subjects were enrolled as control group.The levels of prothrombin time(PT),fibrinogen (FIB),activated partial thromboplastin time(APTT),ANC were compared between the two groups.Results The levels of coagulation,ANC in the observation group were significantly higher than those in the healthy control group,the difference was statistically significant(P<0.05).There were no significant differences in coagulation function,ANC levels between children with stage Ⅰ and Ⅱ(P>0.05).There was no significant difference between the two groups(P>0.05).The levels of coagulation,ANC in children with chemotherapy were significantly lower than those before chemotherapy(P<0.05).There was no significant difference in co-agulation function,ANC level between chemotherapy group and chemotherapy group before chemotherapy (P>0.05).Conclusion Coagulation function and ANC levels are correlated with chemotherapy efficacy in children with lymphoma.Detection of coagulation function and ANC level during chemotherapy is helpful for finding and preventing bleeding in children with lymphoma.

Clinical analysis of primary nephrotic syndrome combined with hypercoagulable state in 57 children / 临床儿科杂志

Objective To explore the clinical characteristics and influencing factors of primary nephrotic syndrome (PNS) combined with hypercoagulability in children. Methods The clinical data of 57 children with primary PNS were analyzed retrospectively. The clinical features and treatment were compared among high coagulation state group, non high coagulation state group and control group (20 children). At the same time, the differences between the simple nephrotic syndrome group (SNS) and nephritic syndrome group (NNS) in hypercoagulable state were analyzed. In addition, the correlation analysis was performed. Results Among 57 patients, there were 50 patients in high coagulation state group and 7 in non high coagulation state group. There was no significant difference in gender, age and clinical manifestations between two groups (P>0.05). The platelet (PLT) count, platelet aggregation (PCT), albumin (Alb), fibrinogen (Fib), D-dimer (D2) were significantly higher than those in the control group, and there were statistically significant differences (P all0.05). All of the 57 patients were improved and has no thrombosis after the treatment. Conclusion Children with primary PNS were usually associated with different degrees of hypercoagulable state, and PLT, Fib, D2 could be used as reference indices for the severity of hypercoagulable state, and the activation of complement system might be related to the occurrence and development of hypercoagulable state.

Impact of Blood-activating and Qi-nourishing Therapy on Hypercoagulable State of Rats After Femur Fracture / 广州中医药大学学报

Objective To explore the impact of blood-activatingand qi-nourishing therapy on the hypercoagulable state of rats after femur fracture.Methods One hundred and twenty SD rats were randomly divided into 4 groups,namely normal group,model group,low-molecular-weight heparin(LMWH) group,combination group (LMWH + Tongmai Decoction),30 rats in each group.The rat model of femur fracture was established.After successful modeling,LMWH group was given subcutaneous injection of LMWH 600 U/kg,and the combination group was given subcutaneous injection of LMWH 600 U/kg together with gastric gavage of Tongmai Decoction,the model group was given subcutaneous injection of the same volume of normal saline.The treatment lasted for 1-7 days after the surgery.The pathologic features of the left great saphenous vein were observed by HE staining method,and the relative volume,thickness and quantity of the blood vessels were also measured.The plasma D-dimer (D-D) and fibrinogen (FIB) levels were determined by biochemical analyzer,and the plasma levels of whole blood viscosity at low shear rate (WBV-lsr) and whole blood viscosity at high shear rate (WBV-hsr) were measured with hemodynamic detector.Results On day 7 after the modeling,less endothelium cells,agglomerative red cells,and large thrombi were found in the great saphenous vein tissue section of the model group under microscope.Compared with the normal group,the levels of D-D,FIB,WBV-lsr and WBV-hsr in the model group at various time points were increased,the difference being significant (P ＜ 0.05).After 7-day treatment,the levels of D-D,FIB,WBV-lsr and WBV-hsr in LMWH group and combination group were lower than those of the odel group,and the decrease in the combination group was superior to LMWH group(P ＜ 0.05).The blood vessel endothelium cells in the combination group were arranged neatly with same cellular width while without enlargement or swelling,the effect being superior to that of LMWH group.Conclusion Blood-activating and Qi-nourishing therapy can effectively relieve hypercoagulable state of rats after femur fracture.

Effect of method for activating blood circulation, removing blood stasis and resolving phlegm on hypercoagulable state and cardiopulmonary function in patients with COPD and pulmonary heart disease / 中国生化药物杂志

Objective To study the effect of method for activating blood circulation, removing blood stasis and resolving phlegm on hypercoagulable state and cardiopulmonary function in patients with COPD and pulmonary heart disease.Methods68 cases of patients with COPD and pulmonary heart disease treated in our hospital were enrolled in the study.According to different treatment methods, they were divided two group.Both groups were treated with routine western medicine and the study group were additionally treated by method for activating blood circulation, removing blood stasis and resolving phlegm.The curative effect was compared between the two groups.ResultsThe condition of respiratory and cardiac insufficiency in the study group was significantly better than that in the control group (P<0.05).The total effective rate of treatment in the study group was significantly higher than that in the control group (94.12% vs 76.47%) (P<0.05).The PT and APTT in the study group were significantly longer than those in the control group, and FIB was significantly lower than that in the control group (P<0.05).ConclusionThe method for activating blood circulation, removing blood stasis and resolving phlegm is effective in the treatment of patients with COPD and pulmonary heart disease.The method can effectively improve the cardiopulmonary function and relieve the hypercoagulable state in patients.

Inhibitory effect of resveratrol on the hypercoagulable state in rats and its relationship with the expression of NF-κB / 中国比较医学杂志

Objective The topic of this study was to study the inhibitory effect of resveratrol on hypercoagulable state in rats and its relationship with the expression of NF-κB. Methods Rats were divided into control and model groups, and resveratrol ( high dose, 60 mg/kg ) , resveratrol ( low dose, 30 mg/kg ) and aspirin ( 10 mg/kg ) were given by intragastric administration for 7 d. Then, the rats were treated by adrenaline with ice bath or thrombin to generate hypercoagulable state. Blood samples were collected to test the prothrombin time (PT), activated partial thromboplastin time ( APTT) and blood viscosity. Vascular endothelial cells were collected to detect the expression of NF-κB by western blotting. Results PT and APTT values of rats in the control, resveratrol (high dose) and aspirin groups were significantly increased than the model group (P< 0. 05). Blood viscosity of rats in the control, resveratrol (high dose) and aspirin groups was significantly lower than the model group (P< 0. 05). The expression of NF-κB was decreased than that of the model group (P< 0. 05). Conclusions Resveratrol in high dose (60 mg/kg) can inhibit hypercoagulable state of rat, which may be related with its effect on decreasing the expression of NF-κB.

Trombosis de senos venosos cerebrales, una manifestación inusual de déficit de proteína S en paciente joven / Cerebral venous sinus thrombosis, an unusual manifestation of protein s deficiency in young patients

Resumen La trombosis venosa cerebral (TSVC) es un tipo de accidente cerebrovascular (ACV) que involucra el lado venoso de la circulación cerebral, incluye trombosis de los senos venosos durales y/o de las venas corticales y profundas del cerebro, es una causa poco común 0,5-1 % de todos los accidentes cerebrovasculares, con una prevalencia estimada en el rango entre 0. 22 a 1,23 / 100.000 / año. Los factores de riesgo para TSVC, están generalmente divididos en riesgos adquiridos (por ejemplo: cirugía, trauma, embarazo, puerperio, síndrome antifosfolípido, cáncer, hormonas exógenas) y los riesgos genéticos (trombofilia hereditaria). Los factores de riesgo más ampliamente estudiados para TSVC incluyen estados protrombóticos, las trombofilias heredadas asociadas con TSVC incluyen deficiencias de antitrombina, proteína C, proteína S (PS), mutación del factor V Leiden y la mutación del gen 20210 de protrombina. La prevalencia del déficit de PS, oscila entre un 0,02 y un 0,03 % en la población general y aumenta hasta un 2 % en pacientes no seleccionados con trombosis. Con una mortalidad cercana al 9 %. El manejo es usualmente médico. Se cita el caso de una paciente de 28 años de edad, con cuadro clínico de cefalea de 1 mes de evolución, con hallazgos en neuroimagen de trombosis de senos transverso y sigmoideo izquierdo con déficit de proteína S.

Summary Cerebral venous thrombosis (TSVC) is a type of stroke (CVA) involving the venous side of the cerebral circulation, including thrombosis of the dural venous sinuses and / or cortical and deep veins of the brain, is a rare cause 0.5-1% of all strokes, with an estimated range between 0. 22 to 1.23 / 100,000 / year prevalence. Risk factors for TSVC, are generally divided into acquired risks (eg, surgery, trauma, pregnancy, postpartum, antiphospholipid syndrome, cancer, exogenous hormones) and genetic risks (hereditary thrombophilia). The most widely studied factors TSVC risk include prothrombotic states, inherited thrombophilia associated with deficiencies TSVC include antithrombin, protein C, protein S (PS), mutation of factor V Leiden mutation and prothrombin 20210 gene. The prevalence of PS deficit ranges between 0.02 and 0.03% in the general population and increases up to 2% in unselected patients with thrombosis. With close to 9% mortality. The operation is usually doctor. It cites the case of a 28-year-old, with clinical symptoms of headache 1 month of evolution with neuroimaging findings transverse sinus thrombosis and left sigmoid with protein S deficiency.

Effect of diabetes mellitus type ii on activated partial thromboplastin time and prothrombin time.

Diabetes mellitus contributes for initiation and progression of micro vascular and macro vascular complications. Complication includes coagulation impairment however Shortened activated partial thromboplastin time (aPTT) values may reflect hypercoaguable state, which is associated with increased thrombotic risk and adverse cardiovascular events. Objective: The present study was conducted to study the aPTT and PT levels in patients with diabetes mellitus type II. Material and method: A sample of 50 persons were selected, 30 patients suffering from DM as type II from Al-wahda teaching hospital, Derna-Libya. At the same time a group of 20 randomly selected healthy adults to participate in the study as control group. Result: The mean value of APTT in T2DM individuals was significant lower (28.95 ±7.54) seconds as compare with control, (34.12±2.82) seconds (P = 0.06). The mean value of prothrombin time (PT) among T2DM individuals was (14.04 ±2.96) seconds and the mean value of PT among healthy individuals was (13.5 ± 1.54) seconds. There was no significant difference in PT of T2DM individuals P ≥ 0.05. Conclusion: From this study, it may be concluded that shorted APTT confirms that T2DM is a hyper-coagulable state due to which there is increased risk of thrombotic events.

XFC improved mechanism of hypercoagulable state in OA patients based on NF-κB signaling pathway:a mechanism exploration / 中国免疫学杂志

Objective:To investigate the relationship between hypercoagulable state and the activation of the NF- kappa B pathway,inflammatory/suppression cytokines in patients with osteoarthritis. Methods:56 patients with OA were divided into two groups according to random number table:XFC group ( 28 cases ) and glucosamine ( GS ) group ( 28 cases ) . Two groups were treated for 3 months. Nine healthy people are healthy control group ( NC) . Determining the expression levels of the index of the NF-κB signaling pathway (p50,p65,TAK1,IκBα) and TNF-α,IL-1,IL-10,platelet activating factor(PAF) in serum by enzyme-linked immunosorbent assay. Detected the level of the indicators and laboratory indexes related with coagulation,observed the changes between the two group, used OA symptoms integral scale, LequesneMG, SF-36 and vas to assess efficacy;and made a correlation analysis. Results: After treatment,FIB,D-D, PAF, PLT, p50, p65, TAK1, IL-1, TNF-α, hs-CRP, ESR, IgG, LequesneMG, symptom integral meter, and VAS integral were significantly higher,APTT,PT,PAF-AH,IL-10 and each dimension integral of SF-36 significantly decreased in 2 groups (P<0. 05). XFC group was better than the GS group in reducing the level of PLT,FIB,TNF-α,p65,TAK1,hs-CRP,ESR,symptom integral meter,and VAS integral and increasing PT,each dimension integral of SF-36, etc (P<0. 05,P<0. 01). The results of Pearson correlation analysis show that PLT,FIB,D-D,PAF had positive correlation with p50,p65,TAK1,IL-1,TNF-α,hs-CRP,ESR,IgG,Le-quesneMG,symptom integral meter,and VAS integral,and negative correlation with IL-10 and each dimension integral of SF-36 ( P<0. 05,P<0. 01). PT had positive correlation with IL-10,GH and PF,and negative correlation with p50,p65,TAK1,IL-1,TNF-α,hs-CRP,ESR,IgG,symptom integral meter,and VAS integral (P<0. 05,P<0. 01). Conclusion: XFC could inhibit the NF-κB signaling pathway, raise the level of IL-10, reduce the expression of IL-1, TNF-α, P50, p65, TAK1 and so on, and reduce the abnormal inflammatory immune response. So as to achieve the purpose of delaying and inhibiting the production of hypercoagulable state,reduce joint disease,relieve the symptoms of joint pain and stiffness,eventually improve the patient’s quality of life.

Effect of three kinds of low molecular weight heparin combined with methylprednisolone on the high coagulation state and renal function in refractory nephrotic syndrome / 中国生化药物杂志

Objective To investigate the effect of three kinds of low molecular weight heparin combined with methylprednisolone on the high coagulation state and renal function in patients with refractory nephrotic syndrome.Methods 140 cases of refractory nephrotic syndrome were divided into four groups, 35 cases in each group.The control group were treated with methylprednisolone.Small, medium, and large dose group in the control group on the basis of the treatment, were given low molecular weight heparin on once every other day, once daily, twice daily treatment, 3075 AxaIU per times.The improvement of renal function and high coagulation state were compared between the four groups before and after treatment.In the course of treatment, the occurrence of adverse reactions was recorded.Results Remission rate in large, medium and small dose group remission rate was higher than the control group(χ2 =4.375,P<0.05); there was no significant difference in remission rate of three different dose groups.The 24h urine protein and ALB of the four groups after treatment were significantly increased, BUN and SCr were significantly lower(P<0.05).The 24h urine protein, ALB, BUN, SCr of improvement of large, medium and small dose group were significantly better than the control group( P<0.05).The 24 h urine protein, ALB, BUN, SCr in large dose group improved significantly better than those in small dose group(P<0.05).The APTT, PT in large, medium and small dose groups after treatment increased significantly, FIB decreased significantly(P<0.05).The improvement of FIB, APTT, PT in large, medium and small dose group were significantly better than the control group after treatment ( P <0.05 ).The FIB, APTT, PT in large dose group improved significantly better than those in medium and small dose group ( P <0.05 ) .Conclusion The low molecular weight heparin combined with methylprednisolone can significantly improve hypercoagulable state and renal function in the patients with refractory nephrotic syndrome, and the large dose of low molecular weight heparin effect is the best, and no significant adverse reactions occurred.