Prognostic Value of Platelet Aggregation Function in Patients with laryngeal Carcinoma.

Background: Laryngeal cancer was one of the most common malignancies of the head in those years. It has become one of the most common causes of death due to its high recurrence rate and high metastasis rate. It was well known that platelets, especially activated platelets, promote the proliferation, division, and invasion of tumor cells. Activated platelets promote cancer progression and metastasis. However, the prognostic value of platelet aggregation function in laryngeal cancer remains poorly understood. The purpose of this study was to investigate the predictive significance of platelet aggregation function in laryngeal cancer. Materials and Methods: Between January 2015 and December 2016, we conducted a retrospective analysis of 203 patients who were diagnosed with laryngeal cancer consecutively. The patients were stratified by platelet aggregation function into two groups: low "adenosine diphosphate induced light transmittance aggregometry (ADP-induced LTA) ≤15.1" and high (ADP-induced LTA >15.1). Pathological tissues from different parts of the operation were collected and the pathologist determined the pathological type. We assessed the prognostic significance of platelet aggregation function using Kaplan-Meier curves and Cox regression. Results: The low cohort had a significantly higher lymphocyte count than the high cohort. Compared with the high cohort, the low cohort had significantly lower levels of platelet-to-lymphocyte ratio (PLR), ADP-induced LTA, and Interleukins (IL)-6. The ADP-induced LTA (hazard ratio, 1.212; P <0.001) was independently related with 5-year overall survival rate. Conclusion: Patients with ADP-induced LTA >15.1 experience poor outcomes. Platelet aggregation function, when elevated, could be a new prognostic indicator for laryngeal cancer.

Application and monitoring of antiplatelet drugs in children with Kawasaki disease / 国际儿科学杂志

Long-term antiplatelet therapy is critical for children with Kawasaki disease.Commonly used antiplatelet drugs have their own advantages and adverse reactions, so they need to be chosen carefully.Some studies have shown that drug resistance may occur in children with Kawasaki disease during antiplatelet therapy, which increases the risk of cardiovascular adverse events, and platelet aggregation function needs to be monitored during medication.This paper reviews the antiplatelet drugs in common use, the drug resistance of antiplatelet drugs and the detection methods of platelet aggregation function in Kawasaki disease, which is helpful to improve the safety of drugs use and reduce the incidence of complications in children.

Application of platelet GPⅡb/Ⅲa receptor inhibitor (A adjuvant) in the detection of platelet aggregation function / 中国输血杂志

【Objective】 To evaluate the effect of adding platelet GPⅡb/Ⅲa receptor inhibitor (A adjuvant) into the Batroxobin cup (A cup) on the accuracy of the thromboelastogram (TEG) platelet aggregation function test using the functional fibrinogen (function fiber cup) test results as a standard. 【Methods】 From December 2019 to May 2020, 100 (persons) whole blood samples were collected from patients who visited the Department of Neurology, Department of Cardiology, Department of General Affairs and Department of Rehabilitation of our hospital for TEG platelet aggregation function test, and the blood standard samples were divided into MA <25 mm group (n=50) and MA≥25 mm group (n=50) according to the A-cup blood clot intensity (MA) value (mm) measured by TEG, the two groups were subdivided into A cup group (n=50, respectively), A auxiliary group (adding A auxiliary in A cup) (n=50, respectively), and functional fiber cup group (n=50, respectively), each subgroup was tested once again. The linear correlation, platelet inhibition and the consistency of drug efficacy interpretation results in platelet Adenosine diphosphate (ADP) and Arachidonic acid (AA) pathway respectively between the three subgroups were compared. 【Results】 (1) In the MA<25mm group, the inhibition rates of ADP and AA pathway in platelet of A cup, A adjuvant and functional fibrin cup subgroups were (32.00±17.44) % vs (30.19±17.44) % vs (30.07±16.18) %, (24.3±33.53) % vs (22.53±30.9) % vs (22.37±31.2) %, respectively (R2 were all>0.975); (2) In the MA≥25 mm group, the inhibition rates of ADP and AA pathway in platelet of A cup, A adjuvant and functional fibrin cup subgroups were (34.34±33.59) % vs (18.45±24.42) % vs (18.01±24.33) %, (23.19±39.33) % vs (8.48±21.75) % vs (8.31±21.7) % ( R2 between the A cup group and the A adjuvant group were all<0.8, and R2 between the A adjuvant group and the functional fibrinogen cup group were all >0.975); (3)Take the test result of the functional fibrinogen cup as the standard, the correct rates of ADP and AA pathway drug efficacy interpretation were 82% (41/50) vs 100% (50/50) and 84% (42/50) vs 100% (50/50) respectively (P<0.05) between the A-cup group and the A adjuvant group, while the interpretation results of drug efficacy of the two pathway were consistent between the A adjuvant group and the functional fibrin cup group (P>0.05). 【Conclusion】 Adding A adjuvant to TEG platelet aggregation function test can effectively inhibit non-specifically activated platelets in the A cup in the detection of platelet aggregation function, truly reflect the function of fibrinogen and improve the accuracy of platelet inhibition rate.

Clinical value of monitoring platelet aggregation function in children with sepsis / 中华实用儿科临床杂志

Objective:To investigate the relationship between platelet aggregation function changes in children with sepsis and its prognosis.Methods:This was a prospective observational study involving 53 children with sepsis and platelet count of > 100×10 9/L who were admitted in the Pediatric Intensive Care Unit (PICU) of Children′s Hospital Affiliated to the Capital Institute of Pediatrics from January 2017 to December 2018.During the same period, 53 age-matched healthy children were selected as the healthy control group.Platelet aggregation function was detected in each participant, and the differences between the two groups were compared.In addition, 53 children with sepsis were sub-divided into risk group (≤80 grades) and non-risk group (>80 grades) according to pediatric critical illness scores (PCIS). They were further divided into sepsis survival group and sepsis death group according to the prognosis within 24 hours of admission.Platelet aggregation function test was performed on the 1 st and 3 rd day of admission, conventional coagulation function and clinical data were detected as well.Their differences between risk group and non-risk group, and sepsis survival group and sepsis death group were compared, so as to analyze the correlation between platelet aggregation function and clinical prognosis of children with sepsis. Results:No significant differences in the gender and age were found between sepsis group and the healthy control group (all P>0.05). In sepsis group, no significant differences in the gender and age were found between risk group and non-risk group (all P>0.05). There were 44 cases (83%) in sepsis survival group and 9 cases (17%) in sepsis death group.Platelet aggregation function was significantly worse in sepsis death group than in the healthy control group (47.4% vs.79.9%, P<0.001). Compared with non-risk group, platelet aggregation function in risk group significantly decreased (32.5% vs.53.4%, P<0.05). Fibrinogen (FIB) and platelet count in risk group were significantly lower than those of non-risk group (3.28 g/L vs.4.53 g/L and 215×10 9/L vs.346×10 9/L, respectively, all P<0.05). Fibrin degradation products (FDP) in risk group was higher than non-risk group(12.1 mg/L vs.6.0 mg/L, P<0.05). There were no significant differences in the prothrombin time, activated partial thromboplastin time and D-Dimer between risk group and non-risk group (all P>0.05). Platelet aggregation function in the death group was significantly lower than that of survival group (11.1% vs.59.7%, P<0.001). On the 1 st and 3 rd day of admission, platelet aggregation function of died children in risk group continued to be low (11.1%, 10.9%), while platelet aggregation function of survival children was relatively high (59.7%, 65.7%). Platelet aggregation function was positively correlated with FIB, Ca 2+ levels and PCIS ( P<0.05, P<0.05 and P<0.001, respectively). Logistic regression analysis showed that platelet aggregation function was a contributing factor to the mortality of children with sepsis.According to receiver operating characteristic curve of platelet aggregation function in predicting the mortality of children with sepsis, area under curve was 0.889, cut-off value was 18.3%, sensitivity was 88.6%, and specificity was 77.8% ( P<0.001), suggesting that a lower than 18.3% of platelet aggregation function predicted an increased risk of death in children with sepsis. Conclusions:In children with sepsis, there is a decrease in platelet aggregation function, while the platelet count has not decreased.Platelet aggregation function in children with sepsis is correlated with the severity of the disease.In detail, reduced platelet aggregation in early sepsis is an alarm of a poor prognosis in children with sepsis.

Recurrent arterial thrombosis of the lower extremity with secondary thrombocythemia due to reperfusion injury: a case report.

Thrombocythemia is an important cause for thrombogenesis and can be classified as essential or secondary according to the etiology. Secondary thrombocythemia (ST), also called reactive thrombocytosis, is caused by a disorder that triggers increased production by normal platelet-forming cells and is characterized in terms of abnormal increased number of platelet in blood and megakaryocytes in bone marrow. Previous reports have found that complications from malignant tumors, chronic inflammation, acute inflammation, acute hemorrhage, spleen resection etc. to be the common causes of ST. A 53-year-old Chinese male with right lower limb arterial ischemic embolism developed recurring arterial thrombosis at the previous site after operation. During his hospitalization, the patient had a platelet count that was positively correlated with alanine transaminase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), α-hydroxybutyrate dehydrogenase (α-HBDH), creatine kinase (CK), and creatine kinase isoenzyme MB (CK-MB) while his thromboelastogram (TEG) and platelet aggregation test obtained by sequential platelet count showed inconsistent platelet function. We describe a case in which ischemia-reperfusion injury caused ST and recurrent thrombosis and analyse the probable cause of contradictory results of different platelet function tests. In thrombolytic therapy, we recommend adding platelet count and two more platelet aggregation tests to the routine laboratory items to aid in the prevention of recurrent thrombosis.

Effect of ticagrelor and clopidogrel on platelet aggregation function after percutaneous coronary intervention in patients with acute coronary syndrome.

In this study, phosphorylation levels of vasodilator stimulated phosphoprotein (VASP) were detected by flow cytometry (FCM) to investigate the effects of ticagrelor and clopidogrel on platelet aggregation function (PAF) after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS).

Relationship between thrombosis and platelet aggregation function in patients with acute cerebral infarction / 国际检验医学杂志

Objective To study the relationship between thrombocytopenia and platelet aggregation func-tion in patients with acute cerebral infarction.Methods Selected 100 patients with acute cerebral infarction re-ceived from our hospital from May 2016 to May 2017 as observation group,and 100 healthy patients as control group.were tested for the blood elasticity,platelet aggregation function and routine coagulation function test. Correlation between Preason and platelet aggregation function and coagulation function in patients with acute cerebral infarction was analyzed by correlation analysis.Results The observation group of patients with R,K levels(6.0 ± 1.8)min,(1.1 ± 0.3)min,were significantly lower than in the control group(6.8 ± 2.2)min and(2.2 ± 0.5)min(P<0.05).The MA、platelet aggregation rate in the observation group was(69.4 ± 5.0) mm、(71.9 ± 11.2)%,significantly higher than the control group(60.1 ± 4.6)mm、(55.7 ± 9.2)%(P<0.05).The levels of DD and FIB in the observation group were(0.4 ± 0.2)mg/L,(4.5 ± 0.7)g/L,both sig-nificantly higher than that in the control group(0.2 ± 0.01)mg/L,(2.7 ± 0.8)g/L,and the differences were statistically significant(all P<0.05).The Preason correlation analysis available:R,K and platelet aggregation in patients with acute cerebral infarction rate were negatively related,DD and FIB,MA and rate of platelet ag-gregation in patients with acute cerebral infarction,DD and FIB were positively correlated relationship(all P<0.05).Conclusion Thrombosis elastic parameters and platelet aggregation function in patients with acute cer-ebral infarction and obvious correlation,blood coagulation function in clinical work by thrombus elastic graph examination is helpful for the evaluation of the patient condition,so as to effectively guide the clinical treat-ment.

A blood meal-induced Ixodes scapularis tick saliva serpin inhibits trypsin and thrombin, and interferes with platelet aggregation and blood clotting.

Ixodes scapularis is a medically important tick species that transmits causative agents of important human tick-borne diseases including borreliosis, anaplasmosis and babesiosis. An understanding of how this tick feeds is needed prior to the development of novel methods to protect the human population against tick-borne disease infections. This study characterizes a blood meal-induced I. scapularis (Ixsc) tick saliva serine protease inhibitor (serpin (S)), in-house referred to as IxscS-1E1. The hypothesis that ticks use serpins to evade the host's defense response to tick feeding is based on the assumption that tick serpins inhibit functions of protease mediators of the host's anti-tick defense response. Thus, it is significant that consistent with hallmark characteristics of inhibitory serpins, Pichia pastoris-expressed recombinant IxscS-1E1 (rIxscS-1E1) can trap thrombin and trypsin in SDS- and heat-stable complexes, and reduce the activity of the two proteases in a dose-responsive manner. Additionally, rIxscS-1E1 also inhibited, but did not apparently form detectable complexes with, cathepsin G and factor Xa. Our data also show that rIxscS-1E1 may not inhibit chymotrypsin, kallikrein, chymase, plasmin, elastase and papain even at a much higher rIxscS-1E1 concentration. Native IxscS-1E1 potentially plays a role(s) in facilitating I. scapularis tick evasion of the host's hemostatic defense as revealed by the ability of rIxscS-1E1 to inhibit adenosine diphosphate- and thrombin-activated platelet aggregation, and delay activated partial prothrombin time and thrombin time plasma clotting in a dose-responsive manner. We conclude that native IxscS-1E1 is part of the tick saliva protein complex that mediates its anti-hemostatic, and potentially inflammatory, functions by inhibiting the actions of thrombin, trypsin and other yet unknown trypsin-like proteases at the tick-host interface.