Combined monitoring of thrombelastography, coagulation function and mean platelet volume/platelet count ratio to evaluate the prognosis of patients with sepsis / 中华急诊医学杂志

Objective:To compare the value of difference between thromboelastogram (TEG), coagulation function and mean platelet volume (MPV)/platelet count (PLT) ratio in sepsis patients with short-term prognosis.Methods:A total of 271 patients with sepsis admitted to the Affiliated Hospital of Xuzhou Medical University from January 2020 to September 2021 were retrospectively analyzed. The clinical data of the patients were recorded, and the SOFA score and APACHE Ⅱ score were calculated. The patients were followed up within 28 days and were divided into the survival group and death group. The TEG, coagulation function and MPV/PLT ratio were compared between the two groups. The independent prognostic factors of Angle, CI, AT-Ⅲ, D-Di and MPV/PLT ratio were confirmed by Logistic regression analysis. The combination of Angle + CI + AT-Ⅲ + D-Di +MPV/PLT ratio was established, and the ROC curve was drawn to evaluate the prognostic value of Angle, CI, AT-Ⅲ and D-Di combined with MPV/PLT ratio in patients with sepsis.Results:The mortality rate of patients with sepsis was 42.4%. The D-Di and MPV/PLT ratio of the death group were significantly higher than those of the survival group, and the differences were statistically significant. Angle, CI and AT-III in the death group were significantly lower than those in the survival group, and the differences were statistically significant. Logistic regression analysis showed that Angle, CI, AT-Ⅲ, D-Di and MPV/PLT ratio were independent predictors of the prognosis of patients with sepsis (all P < 0.05) . The area under the curve of the combined detection of Angle, CI, AT-Ⅲ, D-DI and MPV/PLT ratio to evaluate the prognosis of sepsis at 28 days was 0.931, which was larger than that of Angle, CI, AT-Ⅲ, D-Di and MPV/PLT ratio alone (0.755, 0.790, 0.776, 0.729 and 0.746). The sensitivity and specificity of the combination of Angle, CI, AT-Ⅲ, D-Di and MPV/PLT ratio were 83.5% and 91.0%, which were also higher than those of the single index . Conclusions:Angle, CI, AT-Ⅲ, D-Di and MPV/PLT ratio are independent prognostic predictors of patients with sepsis. The combination of Angle, CI, AT-Ⅲ, D-Di and MPV/PLT ratio has high sensitivity and specificity in evaluating the prognosis of sepsis.

Clinical Research of Qingkailing Injection in Adjuvant Treatment of Sepsis and Heat Syndrome in Children / 中国实验方剂学杂志

Objective:To evaluate the clinical efficacy of Qingkailing injection in the treatment of children with sepsis and heat syndrome， and investigate its anti-inflammatory， anticoagulant and protective effects. Method:Eighty patients were randomly divided into control group and observation group with forty cases in each group according to the number table. Both groups received comprehensive treatment measures such as fluid resuscitation， anti-infection， anti-inflammatory， anticoagulation， vasoactive drugs， and protection of vital organ functions. While patients in observation group additionally took Qingkailing injection， 5-10 mL each time， intravenous drip after dilution， 1 time/day. Treatment course was five days in both groups. Before and after treatment， the scores of quick sequential organ failure assessment （qSOFA）， pediatric critical illness score （PCIS） and acute physiology and chronic health evalution Ⅱ （APACHEⅡ） were graded； procalcitonin （PCT）， serum amyloid A protein （SAA） before and after treatment， heparin-binding protein （HBP）， tumor necrosis factor-<italic>α</italic> （TNF-<italic>α</italic>）， high-sensitivity C-reactive protein （hs-CRP）， interleukin-6 （IL-6）， IL-10， N-terminal brain sodium Peptide precursor （NT-proBNP）， high-sensitivity cardiac troponin T （hs-cTnT） level， cardiac troponin I （cTnI）， creatine kinase isoenzyme （CK-MB）， <italic>D</italic>-dimer （<italic>D-</italic>D ）， fibrinogen （FIB） and antithrombin Ⅲ （AT-Ⅲ） levels were detected. Result:The APACHEⅡ and qSOFA scores in the observation group were lower than those in the control group （<italic>P</italic><0.05）， while the PCIS score was higher than that in the control group （<italic>P</italic><0.05）. The levels of PCT， SAA，HBP，TNF-<italic>α</italic>， hs-CRP and IL-6 in the observation group were lower than those in the control group （<italic>P</italic><0.01）， while the IL-10 level was higher than that in the control group （<italic>P</italic><0.01）. The levels of NT-proBNP， hs-cTnT， cTnI， CK-MB， <italic>D</italic>-D and FIB in the observation group were lower than those in the control group （<italic>P</italic><0.01）， while the AT-Ⅲ activity was higher than that in the control group （<italic>P</italic><0.01）. Conclusion:Qingkailing injection as the adjuvant therapy in children with sepsis and fever syndrome， can play the role of anti-inflammatory， anticoagulant， reducing infection and myocardial damage， thereby reducing the severity of the disease and improving the prognosis.

Effects of tranexamic acid on intraoperative blood transfusion and postoperative thromboelastogram parameters in patients with partial hepatic resection of hydatid hepatica at high altitude / 中国输血杂志

【Objective】 To investigate the effects of tranexamic acid(TXA) on intraoperative blood transfusion(volume) and postoperative coagulation function in patients with partial hepatectomy for hepatic hydatid disease in high altitude area(altitude ≥2 500 m). 【Methods】 Forty-four patients [(39.09±14.70) years old, 19 males and 25 females] underwent elective partial hepatectomy for hydatid after general anesthesia from October 2018 to December 2019 in the Department of Hydatid of Qinghai Provincial People's Hospital, with ASA gradeⅠ~Ⅲ, Child Pugh grade A~B, and normal preoperative coagulation function. They were randomly divided into TXA injection group, who received intravenous injection of TXA 10 mg/(kg·person)(30 min before surgery), and control group, given a placebo needed the equal amounts of injected 0.9% sodium chloride(30 min before surgery). 3 mL of arterial blood was extracted from each patient before intravenous injection and at the end of operation for TEG detection. The intraoperative blood loss and transfusion volume as well as Plt, Hb and TEG parameters before and after surgery were compared between the two groups, and statistical analysis was performed with SPSS22.0 statistical software. 【Results】 The volume of intraoperative blood loss(mL) in TXA group and control group was 300(200, 1 000) vs 1 400(1 000, 2 100), respectively; the units of plasma transfusion(mL) 0(0, 0) vs 380(0, 575); the units of RBC suspension transfusion(mL) 0(0, 400) vs 1 200(800, 600). Preoperative TEG parameters of two groups were similar to each other(P>0.05). The postoperative R, K and Angle(°) of two groups was 8.32±2.24 vs 10.78±2.67, 2.80(2.10, 3.30) vs 3.70(3.20, 4.80) and 54.76±9.48 vs 43.70±9.02, respectively(P<0.05). 【Conclusion】 TXA can significantly improve coagulation functions, as well as effectively reduce intraoperative blood loss and intraoperative blood transfusion in patients with partial hepatic resection of hydatid hepatica in high altitude area.

Effect of vascular interventional therapy on coagulation function in patients with advanced tumors: A retrospective study / 中国肿瘤临床

Objective: To study the changes in coagulation function in patients with advanced tumors before and after vascular interventional therapy. Methods: A total of 174 patients with middle-late stage tumors undergoing oncology vascular interventional treatment at Beijing Hospital Of Traditional Chinese Medicine Affiliated With Capital Medical University, between January 2018 and October 2018 were included in this retrospective analysis. Changes in platelets (PLT) and related blood coagulation indicators were observed before and after vascular intervention. Among them, 63 patients who received relevant indicators detection within a week after vascular intervention were in group A, and 111 patients who received relevant indicators detection 1 month (30±7 days) after vascular intervention were in group B. SPSS version 22 software was used for statistical analysis. Results: In group A, fibrinogen (FIB) and D-dimer (D-D) values significantly increased, activated pattial thromboplastin timeAPITshortened, and PLT values decreased compared to those before treatment (all P0.05) than those before treatment. Before vascular interventional therapy, a total of 58 patients had hypercoagulability, including 28 patients in group A (48.3%) and 30 patients in group B (51.7%). In contrast, after vascular interventional therapy, a total of 71 (40.8%) patients had hypercoagulability, including 40 (56.3%) patients in group A and 31 (43.7%) patients in group B. Conclusions: Vascular interventional treatment can affect the related blood clotting index in the short term, which is intensified in patients with middle-late tumors and a high blood coagulation state. However, over time the coagulation state gradually mitigated and eventually returned to before-treatment levels. These findings suggest that patients' coagulation function should be closely monitored after intervention treatment.

Safety and efficacy of regional citrate anticoagulation in continuous blood purification treatment of patients with multiple organ dysfunction syndrome

The aim of this study was to discuss the safety and efficacy of regional citrate anticoagulation (RCA) on continuous blood purification (CBP) during the treatment of multiple organ dysfunction syndrome (MODS). Thirty-five patients with MODS were divided into two groups: the local citrate anticoagulation (RCA) group, and the heparin-free blood purification (hfBP) group. The MODS severity was assessed according to Marshall's MODS score criteria. Blood coagulation indicators, blood pressure, filter lifespan, filter replacement frequency, anticoagulation indicators, and main metabolic and electrolyte indicators were analyzed and compared between RCA and hfBP groups. RCA resulted in lower blood pressure than hfBP. The filter efficacy in RCA treatment was longer than in the hfBP group. The blood clearance of creatine, blood urea nitrogen and uric acid was better in the RCA group. RCA also led to higher pH than hfBP. Neither treatment resulted in severe bleeding events. In addition, MODS score was positively correlated with prothrombin time and activated partial thromboplastin time but negatively correlated with platelet concentration. RCA is a safer and more effective method in CBP treatment; however, it could also lead to low blood pressure and blood alkalosis.

The study of application of thrombus elastograph in evaluating coagulation function of patients with acute ischemic stroke / 国际检验医学杂志

Objective To evaluate the role of thrombus elastograph (TEG) in evaluating the coagulation function of patients with acute ischemic stroke.Methods Totally 116 cases of patients with acute ischemic stroke and 116 cases of health physical examination people from our hospital were selected as case group and control group.The blood clotting index and thrombelastogram index of the groups were detected.Results In case group of acute phase,fibrinogen (FIB),two D-dimer (D-D),maximum blood clot strength (MA),0.5 h blood clot reduction rate of MA (LY30),alpha angle,integrated coagulation index (CI) and blood clot strength (G) were significantly higher than those of control group and the recovery period group.The difference was statistically significant(P＜0.01).In cases of acute phase,activated partial thromboplastin time (APTT),prothrombin time (PT),PT-INR,reaction time (R),clot formation time (K value) were significantly lower than those in the healthy control group and the recovery period cases,the difference was statistically significant (P＜0.01).MA,LY30,α Angle and CI were negatively correlated with PT,APTT,PT-INR,and were positively correlated with FIB,D-D(P＜0.05);R value,K value were positively correlated with PT,APTT,PT-INR,and were negatively correlated with FIB,D-D(P＜ 0.05).Conclusion TEG plays a significant role in monitoring and evaluating coagulation function in patients with acute ischemic stroke,and has important evaluation effect on the prognosis of disease.It is worthy of clinical application.

Effects of mistral-air inflatable blanket on neonatal blood coagulation function after surgery for general anesthesia / 国际儿科学杂志

Objective To evaluate the value of mistral-air inflatable blanket in neonatal temperature,postoperative complications,and the influence of the blood coagulation function after surgery undergoing general anesthesia.Methods A total of 60 newborns with laparotomy operation undergoing general anesthesia were randomly divided into two groups,the control group and the observation group,30 persons each group.The newborns were given mistral-air inflatable blanket in the observation group,and conventional methods in the control group,two groups were transferred to Postanesthesia Care Unit by incubator at 37℃.The introperative nasopharyngeal temprature,HR,MAP and SpO2 were recorded before induction (T0),30 minutes during operation (T1),extubated instantly (T2),15 minutes during PACU (T3),30 min during PACU (T4).The extubation time and the incidence of apnoea and hyoxemia were recorded after operation.PT,APTT,TT and Fib were tested before induction and extubated instantly.Results The temperature of intraoperative and postoperative period were higher in the observation group than the control group,the difference was significant(P ＜ 0.05).The heart rates of intraoperative and postoperative period is significantly higher in the control group than the observation group,the difference was significant(P ＜ 0.05);the mean arterial pressure were no significant statistical difference(P ＞ 0.05).The observation group extubation time were less than the control group,the difference was significant (P ＜ 0.05).There was no significant difference about the incidence of hypoxemia and apnea in two groups(P ＞ 0.05).The PT,APTT,TT and Fib in the observation group were better than the control group,the difference between the groups was significant(P ＜ 0.05).Conclusion Mistral-air inflatable blanket can effectively prevent the decrease of the body temperature during operation and PACU,reduce the exduction time and postoperative complications,and protect blood coagulation function.

Effects and Safety Observation of Different Treatment Courses of Rivaroxiban in Prevention and Treat-ment of Deep Venous Thrombosis after Total Hip Replacement / 中国药房

OBJECTIVE:To observe the effects and safety of different treatment courses of rivaroxaban in prevention and treatment of deep venous thrombosis(DVT)after total hip replacement. METHODS:The clinical data of 127 patients under-went selective total hip replacement in our hospital during Dec. 2014-Dec. 2015 were selected and analyzed retrospectively. They were divided into group A [83 cases,subdivided into group A1(40 cases)and A2(43 cases)by treatment course] and group B (44 cases) according to anticoagulant duration. Group A was given Rivaroxaban tablet 10 mg,po,qd,6-8 h after surgery;the treatment course of group A1 was 5 weeks(35 d)while that of group A2 was 2 weeks(14 d). Group B was giv-en Enoxaparin sodium injection 5000 AxaIU,sc,qd,12d before surgery;and then given Enoxaparin sodium injection 5000 AxaIU,sc,qd,after surgery;the treatment course lasted for 2 weeks. The incidence of DVT were compared among 3 groups as well as thrombin time(TT),activated partial thromboplastin time(APTT),hemoglobin(Hb)content,whole blood viscos-ity,plasma viscosity,platelet count and anticoagulant safety 3 days before surgery and after treatment. RESULTS:The inci-dence of DVT in group A1 was 0,which was significantly lower than that in group A2 (9.30%) and group B (11.36%), with statistical significance(P0.05). Wheth-er 3 d before surgery or after treatment,there was no statistical significance in PT,APTT,Hb content,whole blood viscosi-ty,plasma viscosity and platelet count among 3 groups (P>0.05). No major bleeding events or pulmonary embolism was found in 3 groups. The incidence of mild bleeding events in group A was 5.00%,which was slightly higher than that in group A2 (2.33%) and group B (2.27%),without statistical significance (P>0.05);there was no statistical significance between group A2 and group B(P>0.05). CONCLUSIONS:Rivaroxiban long-term anticoagulation after total hip replacement has no significant effect on coagulation function and platelet,not only decrease the incidence of DVT,but also will not increase no bleeding with good safety.

Effect of Continuous Blood Purification on Inflammatory State and Immune Response in Patients with Multiple Injury and Sepsis / 现代生物医学进展

Objective:To study the effect of continuous blood purification on inflammatory state and immune response in patients with multiple injury and sepsis.Methods:88 patients with multiple injury and sepsis who were treated in our hospital from January 2015 to May 2016 were selected as the research object,they were divided into the control group (n=44) and observation group (n=44) according to random number table method.The control group was given conventional treatment,and the observation group was given continuous blood purification treatment.The acute physiology and chronic health conditions Ⅱ (APACHE Ⅱ)score was observed in two groups Ⅱ at 3 d after treatment.The serum content of Interleukin-2(IL-2),Interleukin-4(IL-4),Interleukin-10(IL-10) and interferon-γ (IFN-γ) were detected by ELISA method.The levels of CD3 +,CD4 +,CD8 + and NK cell were analyzed by flow cytometry.The urea nitrogen (BUN),serum creatinine (Scr),prothrombin time (PT),thrombin time (TT),activated partial blood coagulation time (APTT) were tested by automatic biochemical analyzer.Results:The APACHE Ⅱ score,BUN and Scr levels in observation group were lower than the control group (P＜0.05).The content ofIL-2,IL-4,IL-10 and IFN-γ in observation group were lower than the control group (P＜0.05).The levels of CD3+,CD4+,CD8+ and NK in observation group were higher than the control group (P＜0.05).The levels ofPT,TT and APTT in observation group were lower than the control group (P＜0.05).Conclusion:Continuous blood purification in patients with multiple injury and sepsis had better clinical curative effect,can reduce inflammation,improve immune function and the function of blood coagulation.

Impact of rehabilitation training combined with low molecular heparin calcium on functional recovery and venous thrombosis of postoperative period of hip fracture in the elderly / 中国基层医药

Objective To study the impact of rehabilitation training combined with low molecular heparin calcium on functional recovery and venous thrombosis of postoperative period of hip fracture in the elderly.Methods 86 elderly patients with hip fracture surgery were divided into the control group(43 cases)and observation group (43 cases)according to random number table method.The control group was given low molecular heparin calcium, and the observation group was given rehabilitation training combined with low molecular heparin calcium.After four weeks,the hip functional recovery and venous thrombosis occurrence were observed in the two groups.The levels of blood rheology indicators such as blood high shear viscosity,shear viscosity,low shear viscosity,erythrocyte aggrega-tion index and coagulant function index of thrombin time and D -dimer were detected.Results The scores of hip joint pain,joint function,joint mobility,deformity and Harris score in the observation group were higher than those in the control group,the differences were statistically significant(t =3.713,3.224,3.345,1.861 and 8.087,all P <0.05).The incidence rate of venous thrombosis in the observation group was 6.89%,which was lower than 23.26%in the control group,the difference was statistically significant (χ2 =4.440,P =0.035).After 4 weeks treatment,the levels of the whole blood high shear viscosity,shear viscosity,low shear viscosity and erythrocyte aggregation index in the observation group were lower than those in the control group,the differences were statistically significant (t =2.092,2.590,1.716 and 2.590,all P <0.05).After treatment,the level of D -dimer in the observation group was lower than that in the control group,and the prothrombin time in the observation group was higher than that in the con-trol group,the differences were statistical significance(t =7.510 and 2.151,all P <0.05).Conclusion The rehabil-itation training combined with low molecular heparin calcium can promote hip joint function recovery of postoperative period of hip fracture in the elderly,reduce the incidence of venous thrombosis,improve blood rheology and blood coagulation function indicators.

Clinical significance of the application of thromboelastogram in the perioperative peri-od of gastric cancer patients / 中国肿瘤临床

Objective:To monitor the dynamic changes in coagulation function and assess their clinical significance in patients with gas-tric cancer by using thromboelas to gram (TEG). Methods:A total of 178 patients with gastric cancer from March 2014 to May 2015 in Xinxiang Central Hospital were selected as the experimental group. The patients were grouped based on different tumor stages, inva-sion depths, and lymph node metastasis. The TEG results of all patients were dynamically monitored before and after operation, and 60 healthy persons were selected as normal control group. Blood coagulation change was analyzed by comparing the TEG test results. Results:Compared with those of the control group, the TEG parameters of the experimental group showed significantly decreased R and K values, as well as significantly increased Angle, CI, and MA values, and the differences were statistically significant (P<0.05). In the experimental group, the K values were significantly decreased after operation, whereas Angle, MA, and CI were significantly in-creased (P<0.05). No significant changes were observed in R, LY30, and others. TEG values were significantly different in the compari-son of values for tumor patients with different stages, different tumor infiltration degrees, and with or without lymphatic metastasis. Conclusion:Blood hypercoagulability in the perioperative period was observed in patients with gastric cancer and was positively corre-lated with tumor stages, tumor infiltration degrees, and lymphatic metastasis. Dynamic monitoring of gastric cancer perioperative TEG can provide valuable information for clinical treatment, improve the safety of gastric cancer surgery, and reduce postoperative compli-cations associated with active clinical significance.

Investigation on change regulation of blood coagulation function before and after treatment of snake bite patients / 国际检验医学杂志

Objective To explore the change regulation of blood coagulation function before and after treatment of snake bite pa‐tients .Methods A total of 226 hospitalized patients with clear diagnosis belong to what kind of snakes in the past two years were selected in this study ,39 cases were bit by coral ,76 cases were bit by trimeresurus stejnegeri ,47 cases were bit by cobra ,24 cases bit by king cobra ,40 cases were bit by adder .Five blood coagulation indexes were determined before and after treatment various pe‐riods for these patients .The tested results were made to statistical analysis according to kind of snakes ,periods and disease condi‐tion .Results D‐D level obvious .rise before treatment for the severe cases patients of coral snake bite (P0 .05) before and after treatment ,only D‐D level of the severe cases had statistical significance before treat‐ment in contrast to the mild cases of cobra bite (P< 0 .05) .The changes of 5 item blood coagulation indexes were all very large whether mild or severe for viper bite patients ,a number of comparisons had statistical significance difference (P<0 .05) whether before or after treatment and whether mild or severe for viper bite patients .Conclusion The bite of coral snake ,cobra and king co‐bra affect little for the blood coagulation function .The severe cases patients of trimeresurus stejnegeri bite might lead to more seri‐ous blood coagulation function abnormality but the recovery is faster after treatment .The viper bite might lead to maximum blood coagulation function abnormality and the recovery is slow after treatment .

Clinical Study on the Effects of Ulinastatin Injection Combined with Xuebijing on Coagulation Function and Systemic Inflammatory Response in Patients with Sepsis after Burn / 中国医科大学学报

Objective to observe the effects of ulinastatin(UtI)and xuebijing on treatment of burns sepsis after coagulation and systemic inflam-mation. Methods A total of 103 patients diagnosed of sepsis in burn department of our hospital during 2009-01 - 2014-01 were recruited for the study and randomly divided into 2 groups. the control group(51 cases)received conventional fluid resuscitation,mechanical ventilation,renal re-placement,wound dressing or operation,metabolic nutrition support;the treatment group(52 cases)received vein infusion of xuebijing 100 mL, bid on the basis of conventional therapy,ulinastatin 400 000 U intravenous drip,bid,for 10 d. the blood routine,blood coagulation function and in-flammatory reaction index and plasma lipopolysaccharide(LPS),tumor necrosis factor-alpha(tNF-alpha),interleukin-6(IL-6),interleukin-10 (IL-10),C- reactive protein(CRP)and procalcitonin(PCt)of the patients in each group were respectively detected before treatment and after treatment in the 1,3,7,10 days. Results After treatment of coagulation,indexes of blood fibrinogen degradation product(FDP),plasma fibrino-gen(FIB),blood concentration of two D- dimer(D-Dt),platelet and inflammatory reaction index compared were significantly improved compare with those before treatment in both two groups(P < 0.01). In addition,the treatment group showed significantly better effects than the control group, and the difference was statistically significant(P < 0.05). 7 d after treatment inflammation index levels in treatment group decreased more significant-ly compared with the control group,and the difference was significant(P < 0.05). Conclusion Combined application of xuebijing,ulinastatin with auxiliary treatment of post-burn sepsis can reduce the systemic inflammatory response,improve blood hypercoagulable state.

Blood coagulation function changes and intervention effects of metformin in patients with impaired glucose tolerance / 中国医师进修杂志

Objective To investigate the blood coagulation function changes and intervention effects of metformin in patients with impaired glucose tolerance.Methods One hundred patients with impaired glucose tolerance and 50 healthy volunteers (control group) were recruited.The patients with impaired glucose tolerance were divided into test group 1 and test group 2 by random digits table method.The patients in test group 2 were given metformin and the patients in test group 1 were given the same dosage of placebo.The oral glucose tolerance test (OGTT),glycosylated hemoglobin (HbA1c),prothrombin time (PT),activated partial thromboplastin time (APTT),thrombin time (TT) and fibrinogen (Fib) level were determined before and after treatment.Results Compared with those in control group,the patients in test group 1 and test group 2 had higher level of 2 h postprandial blood glucose (2 h PBG),HbA1c and Fib,and lower level of APTT,PT (P ＜ 0.05).The level of 2 h PBG,HbA1c and Fib in test group 2 were significantly lower than those in test group 1,(6.6 ± 2.5) mmol/L vs.(7.9 ± 3.6) mmol/L,(5.2 ± 1.3)％ vs.(5.8 ± 1.4)％,(3.0 ± 1.0) g/L vs.(3.6 ± 1.2) g/L,and the level of APTT and PT were significantly higher than those in test group 1,(34.3 ± 6.8) s vs.(31.6 ± 6.5) s,(12.6 ± 0.7) s vs.(12.3 ± 0.7) s,P ＜ 0.05.Compared with those in control group,there were no significant differences (P ＞ 0.05).Pearson line correlation analysis revealed that APTT and PT had negative correlation with 2 h PBG and HbA1c (P ＜ 0.01),and Fib had positive correlation with 2 h PBG and HbA1c (P ＜ 0.01).TT had no correlation with 2 h PBG and HbA1c (P ＞ 0.05).Conclusion Blood coagulation function of patients with impaired glucose tolerance may have some alteration,and appropriate therapeutic intervention can reduce the risk factors for cardiovascular disease.

Researches on inflammatory factor and blood coagulation in patients with laparoscopic gastric cancer radical surgery / 天津医药

Objective To investigate the change of inflammatory factor and blood coagulation in patients with laparo?scopic gastric cancer radical surgery. Methods Data of seventy-seven stomach cancer patients hospitalized in our hospital and received the surgical treatment from June 2012 to June 2014 were retrospectively analyzed. Thirty-eight of these pa?tients underwent laparoscopic treatment (laparoscopic group) and 39 cases received laparotomy treatment (laparotomy group). The values of interleukin-6 (IL-6), IL-8 and tumor necrosis factor alpha (TNF-α) were analyzed at the time points of preop?eration and 6 h, 24 h after the surgery in two groups. The levels of activated partial thromboplastin time (APTT), prothrombin time (PT), international standardization ration (INR), fibrinogen (FIB) and D dimer (D-D) were also analyzed at the same time points in two groups. The postoperative thrombosis and tumor recurrence rate were also analyzed in two groups of pa?tients. Results There were no significant differences in the gender, age, the size of tumor, differentiation degree and TNM staging between two groups of patients. The serum levels of IL-6, IL-8 and TNF-αwere significantly increased after surgery in two groups (P < 0.01), and which were significantly higher in laparotomy group than those of laparoscopic group (P<0.01). The levels of APTT, PT and INR were significantly lower after surgery in two groups of patients, and which were signifi?cantly lower in laparoscopic group than those of laparotomy group (P<0.05). The levels of FIB and D-D were significantly increased after operation in two groups of patients (P<0.05), which were significantly higher in laparoscopic group than those of laparotomy group (P<0.05). The postoperative recurrence of cancer was less in laparoscopic group than that of lapa?rotomy group. But, the postoperative thrombosis was more in laparoscopic group than that of laparotomy group. Conclusion There was less release of inflammatory mediators and less effect on the body’s immune function in patients with laparoscopic gastric cancer radical surgery. But, the surgery has a large influence in blood coagulation, we should pay attention to it in the clinical treatment.

Comparison on activating blood circulation effects of Jiaoai Decoction and Siwu Decoction on acute blood stasis rats / 中草药

Objective: To compare the effects of Jiaoai Decoction and Siwu Decoction on hemorheology, blood coagulation function, and platelet aggregation in acute blood stasis rats, and reveal that Jiaoai Decoction evolved into Siwu Decoction could increase the efficacy of activating blood circulation and dissipating blood stasis. Methods: Ice water bath and sc injection of adrenaline were both used to establish the acute blood stasis rat model. The whole blood viscosity (WBV), plasma viscosity (PV), haematocrit (HCT), thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT), plasma fibrinogen (FIB), and platelet aggregation (PAG) were detected to observe the effects of Jiaoai Decoction and Siwu Decoction on the acute blood stasis rat model. Results: Compared with the normal control group, the model group could significantly increase hemorheological indices (P < 0.01), shorten TT, PT, and APTT (P < 0.01), and increase the FIB content (P < 0.01) and platelet aggregation (P < 0.01). Compared with the model group, Siwu Decoction could significantly decrease WBV, PV, and HCT (P < 0.05, 0.01), prolong TT, APTT, and PT (P < 0.05), and reduce the content of FIB (P < 0.01) and platelet aggregation (P < 0.01). The mid-dose Jiaoai Decoction could significantly decrease WBV in 1 s-1 and HCT (P < 0.05, 0.01), prolong APTT (P < 0.05) and shorten PT (P < 0.01), and reduce the platelet aggregation (P < 0.01). Compared with mid-dose Jiaoai Decoction, Siwu Decoction could significantly prolong the TT (P < 0.01). Conclusion: Jiaoai Decoction evolved into Siwu Decoction could increase the efficacy of activating blood circulation and dissipating blood stasis. Meanwhile, the study reveals the scientific evidence for Jiaoai Decoction and Siwu Decoction in clinical application.

Clinical significance of the changes of coagulation and fibrolysis parameters in malignant lymphomas / 白血病·淋巴瘤

Objective To explore the clinical significance of the coagulation and fibrolysis parameters changes for the knowledge of complicated thrombosis after chemotherapy in malignant lymphomas. Methods Morning fasting anti-coagulation blood samples were taken to detect plasma prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB) and thrombin time (TT) with automatic coagulation analyzer in 71 hospitalized malignant lymphomas and 20 normal controls. The plasma D-dimer levels of the two groups were detected with immunoturbidimetry. Results The levels of plasma APTT, Fib and D-dimer in 71 malignant lynphomas were (30.44±1.43) s, (3.28±0.20) g/L, (297.05±56.59) μg/L respectively, which were significantly higher than those in normal controls at the levels of (23.72±0.76) s, (2.57±0.22) g/L, (94.50±26.07) μg/L respectively (P ＜0.05). The coagulation and fibrolysis parameters were of no statistic differences between the normal controls and lymphomas of stage Ⅰ and Ⅱ (P ＞0.05). The APTT and Fib levels in lymphomas of stage Ⅲ and Ⅳ were higher than those in normal controls and lymphomas of stage Ⅰ and Ⅱ (P ＜0.05). There are 7 malignant lymphomas complicated venous thrombosis . Of the 7 cases, the FIB and D-dimer levels were higher than those of stage Ⅰ and Ⅱ, furthermore the D-dimer levels were higher than those of stage Ⅲ and Ⅳ. Conclusion The abnormalities of coagulation and fibrolysis parameters occurred in malignant lymphomas with requirement of periodic monitoring. After chemotherapy, the lymphoma patients had a high incidence of venous thrombosis, which need early prevention for prolongation of the survival.

Changes in metabolic indexes and anesthesia administration during perioperation in patients undergoing orthotopic liver transplantation / 西安交通大学学报(医学版)

Objective To investigate the changes in metabolic indexes and anesthesia administration during perioperation in patients undergoing orthotopic liver transplantation. Methods Eleven patients who underwent orthotopic liver transplantation were selected. Their pH, BE, HCO 3 -, K +, Ca 2+, blood glucose, PT, APTT and FIB were assessed at 60 min of pretransplantation, 20 min and 40 min of liver transplantation, 20 min and 40 min of new liver reperfusion. Results The pH, BE, HCO 3 -, K +, Ca 2+ during 20 min and 40 min of liver transplantation decreased more significantly than those during pretransplantation 60 min, PT and APTT extended markedly, the level of blood glucose did not change markedly; pH, BE, HCO 3-, K +, Ca 2+ and the level of blood glucose during new liver reperfusion 20 min and 40 min increased significantly compared to those during liver transplantation 20 min and 40 min; PT, APTT and FIB did not change markedly. Conclusion Metabolic indexes during liver transplantation change more markedly than those during pretransplantation or new liver reperfusion.