Impact of heparin on coagulation index during the therapy of molecular adsorbent recirculating system in patients with liver failure / 中南大学学报(医学版)

OBJECTIVE@#To investigate the impact of coagulative parameters on different anticoagulation systems in molecular adsorbent recirculating system (MARS) in subjects with liver failure, and to evaluate the safety of different anticoagulation methods .@*METHODS@#A prospective experimental observation was designed. According to anticoagulation Methods , 174 MARS treatment sessions for 146 patients with liver failure and prothrombin time activity percentage (PTA) ≤ 40% were randomly divided into 2 groups: 92 MARS treatment sessions in the heparin-free group and 82 in the low-dose heparin group. Time points of 0, 0.5, 1, 2, 3, 4, 5 and 6 h were selected to observe the coagulation changes of prothrombin time (PT), PTA, thrombin time (TT), activated partial thromboplastin time (APTT) and international normalized ratio (INR) dynamically. Adverse events such as line / filter coagulation, rupture and bleeding were also investigated and compared due to frequency and severity between the 2 groups.@*RESULTS@#There was no difference in PT, PTA, INR between the 2 groups, but significant differences were observed in APTT and TT and fibrinogen (Fbg). APTT and TT levels in the low-dose heparin group was increased rapidly after the first given dose of anticoagulant heparin and reached the peak within 30 min.The levels at each time point was statistically different between the 2 groups (P<0.05). A significant difference in the Fbg level was obtained between the 2 groups. In the low-dose heparin group it was stabilized and increased slightly at the end of the treatment. While in the heparin-free group it was decreased gradually and reached a ravine at the end of the treatment. A curve was observed after 2.5 h treatment between the 2 groups (P=0.001). There were 2 cases of severe bleeding after MARS was finished in the heparin group, and 1 was terminated because of degree III clotting in the heparin-free group.@*CONCLUSION@#Fibrinogen should be adsorbed while the blood touches the MARS circuit path and anticoagulants can prevent it. Comprehensive analysis of blood platelet count (BPC), fibrin degradation products (FDP), D-dimer and clinical symptoms is critical and required to determine the coagulation status to select an anticoagulation system before MARS. The use of low dose heparin in MARS improves the disorder of hypercoagulable state during the high coaguation period, while heparin-free during low coagulation period can effectively prevent the occurrence of bleeding and improve the mechanism of blood coagulation by reducing heparin-like substance in the blood.

Anti-aging effects of polysaccharides from rhizomorph of Armillaria mellea / 中成药

AIM: To study the anti-aging effects of polysaccharides from rhizomorph of Armillaria mellea(ARP) on fruit fly and mouse. METHODS: Regarding fruit files and D-galactose induced aging mice as research objects,observing the fruit flies lifespan;The ability to learn and memorize on model mice were observed by jumping platform test and maze test,the body weight,thymus and spleen index,SOD and GSH-Px activities、MDA and NO levels in serum,liver and brain were measured. RESULTS: ARP could significantly lengthen the lifespan of fruit flies;Obviously improve the ability to learn and memorize,markedly increase the body weight and resist the atrophy of thymus and spleen of model mice,SOD and GSH-Px activities increased obviously,MDA and NO levels decreased dramatically on model mice. CONCLUSION: ARP has anti-aging effects by immune-regulatory and eliminating free radicals.