[Clinical Characteristics and Risk Factors of Low Fibrinogenemia Induced by Hemocoagulase].

OBJECTIVE: To investigate the clinical characteristics and risk factors of low fibrinogenemia (LF) induced by hemocoagulase. METHODS: Clinical data of 57 patients with hypofibrinogenemia (LF group) treated with hemocoagulase during Jan.2015 to Oct. 2018 in our hospittal were analyzed retrospectively. The control group consisted of 60 patients who did not develop hypofibrinogenemia treated with hemocoagulase. The clinical characteristics were compared between these two groups, the univariate analysis and multivariate analysis were also performed. RESULTS: In LF group, the fibrinogenemia occurred on 5.4(σ=1.067) days after use of hemocoagulase，with the main manifestations as bleeding from the operation or wound site, the decrease of fibrinogen (0.694 g/L,σ=0.211), the increase of D-dimer (4.468µg/mL,σ=1.442) and the recovery of Fib on the day 3.93 (σ=0.563) after drug withdrawal. There were significant differences in age, sex, primary disease, origin of snake venom, course of treatment, complication of hepatic and renal insufficiency and route of administration between the 2 groups (P＜0.05). Multivariate logistic regression analysis showed that age(P=0.007,OR=11.248), course of treatment (P＜0.001,OR=72.104) and route of administration (P=0.049,OR=13.389) were risk factors for hypofibrinogenemia. CONCLUSION: The use of hemocoagulase should be vigilant against the occurrence of hypofibrinogenemia. Old age, long course of treatment and the intravenous administration may increase the risk of hypofibrinogenemia.

[Analysis of the Immune Efficacy and Influencing Factors of Different Dose of Hepatitis B Vaccine in Patients with Lymphoma].

OBJECTIVE: To investigate the conversion rate from negative to positive (positive rate) of HBsAb in lymphoma patients inoculated with different dose of hepatitis B vaccine, to evaluate the immune efficacy of different dose of hepatitis B vaccine, and to analyze the influencing factors. METHODS: Two hundred thirty six patients with lymphoma were selected, whose 5 indexes of hepatitis B (HBsAg, HBsAb, HBeAg, HBeAb and HBcAb) were all negative confirmed by ELISA. The hepatitis B vaccine was inoculated according to 0, 1 and 6 months immune procedures at 1-2 weeks before chemotherapy. The HBsAb level was detected at 1 month after the immunization, the differences in each indexes between HBeAb+ and HBeAb- patients were compared. RESULTS: The positive rate of HBsAb was 75% in all patients with lymphoma.The positive rate of high dose (20 µg) group was 81.4%, which was significantly higher than that of the low dose (10µg) group with 68.6% (χ2=5.09, P＜0.05). The positive conversion rate of HBsAb significantly higher in the patients of young, female, B-cell (except DLBCL subtype), early Ann Arbor stage, and the treatment regimens without glucocorticoid and rituximab. There were no statistical significances in systemic symptoms or no and treatment regimens with or without lenalidomide. Two doses of hepatitis B vaccine not displayed obvious adverse reactions. CONCLUSION: The high dose of hepatitis B vaccine can achieve better immune efficacy than that of the low dose in the patients with lymphoma.

[Inhibitory Effect of High Concentration Insulin on the Proliferation of Human Leukemia Cell Strain K562].

OBJECTIVE: To study the impact of high concentration insulin on the proliferation and apoptosis of K562 cell strain. METHODS: K562 cells were treated with different concentrations of insulin. The proliferation activity was tested by CCK-8 assay, cytometry, and trypan blue exclusion. The alterations in glucose concentration of the culture media were monitored while the apoptosis of K562 cells was detected by flow cytometry. The effects of high concentration insulin on the proliferation of K562 cells were inhibited by varying concentrations of insulin-like growth factor-1 (IGF-1) and Suramin. RESULTS: Under the range of concentration (0.1-1 mU/mL), insulin facilitated the proliferation of K562 cells. In contrast, insulin at high concentrations (1.6-100 mU/mL) had the opposite effect, in a dose- and time-dependent manner. Different concentrations of glucose in the culture medium had no significant influence on the inhibitory effect of high concentration insulin on the proliferation of human leukemia cell strain K562. At low concentration insulin inhibited the apoptosis of K562 cells, in a dose-dependent manner. In contrast, insulin at high concentration had the opposite effect, in a dose-dependent manner. Furthermore, IGF-1 reversed the inhibitory effect of high concentration insulin on the proliferation of K562 cell in a dose- and time-dependent manner. Suramin, which is an IGF-1 receptor non-specific blocker, had the opposite effect on K562 cells, also in a dose- and time-dependent manner. CONCLUSION: These results indicate insulin has a dual effect on K562 cells. The dual effect is probably mediated by the binding of insulin and IGF-1R. Inhibitory effect of high concentration insulin on the proliferation of K562 cells is unrelated with the glucose metabolism in the culture media.