Omega-3 Fatty Acids and Markers of Thrombosis in Patients with Atrial Fibrillation.

Omega-3 fatty acids (n-3 FAs) are associated with a lower risk of ischemic stroke in patients with atrial fibrillation (AF). Antithrombotic mechanisms may in part explain this observation. Therefore, we examined the association of n-3 FAs with D-dimer and beta-thromboglobulin (BTG), markers for activated coagulation and platelets, respectively. The n-3 FAs eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), docosapentaenoic acid (DPA) and alpha-linolenic acid (ALA) were determined via gas chromatography in the whole blood of 2373 patients with AF from the Swiss Atrial Fibrillation cohort study (ClinicalTrials.gov Identifier: NCT02105844). In a cross-sectional analysis, we examined the association of total n-3 FAs (EPA + DHA + DPA + ALA) and the association of individual fatty acids with D-dimer in patients with detectable D-dimer values (n = 1096) as well as with BTG (n = 2371) using multiple linear regression models adjusted for confounders. Median D-dimer and BTG levels were 0.340 ug/mL and 448 ng/mL, respectively. Higher total n-3 FAs correlated with lower D-dimer levels (coefficient 0.94, 95% confidence interval (Cl) 0.90-0.98, p = 0.004) and lower BTG levels (coefficient 0.97, Cl 0.95-0.99, p = 0.003). Likewise, the individual n-3 FAs EPA, DHA, DPA and ALA showed an inverse association with D-dimer. Higher levels of DHA, DPA and ALA correlated with lower BTG levels, whereas EPA showed a positive association with BTG. In patients with AF, higher levels of n-3 FAs were associated with lower levels of D-dimer and BTG, markers for activated coagulation and platelets, respectively. These findings suggest that n-3 FAs may exert antithrombotic properties in patients with AF.

Chinese traditional herbs enhanced the clinical efficacy of low-molecular-weight heparin in the treatment of recurrent spontaneous abortion complicated with thrombophilia.

Thrombophilia is an important cause of recurrent spontaneous abortion (RSA). The treatment of thrombophilia is beneficial to the prevention of RSA. Therefore, we explored the clinical effect of Chinese traditional herbs with the effects of invigorating the blood, tonifying the kidney and calming the fetus in the treatment of RSA complicated with thrombophilia. We retrospectively analyzed the clinical outcomes of 190 RSA patients combined with thrombophilia using different treatment methods. The traditional Chinese medicine group was treated with kidney-invigorating, blood-activating and fetus-soothing herbs and the western medicine group was treated with low molecular weight heparin (LMWH), and the traditional Chinese medicine combined with western medicine group was treated with LMWH plus Chinese traditional herbs with the effects of kidney tonifying, blood activating and fetus stabilizing. After treatments, platelet aggregation rate, plasma D-dimer and uterine artery blood flow resistance were significantly reduced in the LMWH plus herbs compared to the simple herbs and LMWH group (P < 0.0167). The LMWH plus herbs group significantly accelerated the growth of fetal bud compared with other groups (P < 0.0167). Moreover, the LMWH plus herbs group improved traditional Chinese medicine syndrome scores (P < 0.0167), showing a better clinical efficacy. Adverse reactions occurred in five patients in the LMWH group but not in the simple herbs and LMWH plus herbs group during the treatment period. Therefore, our study shows that for the treatment of RSA complicated with thrombophilia, Chinese traditional herbs plus LMWH can improve the blood supply of the uterus during pregnancy and contribute to a favorable environment for the growth of the fetus. Chinese traditional herbs exert a good curative effect with few adverse reactions.

Effect of breathing intervention in patients with COVID and healthcare workers.

Background: Regulated breathing facilitates ventilation and reduces breathlessness. However, the effect of Yogic breathing on patients with COVID remains unclear. We aimed to evaluate the efficacy of two breathing protocols, i.e., short breathing technique (SBT) and long duration breathing technique (LBDT). Methods: Three groups including COVID-positive patients, COVID-recovered patients, and healthcare workers (HCWs) were included in the study and segregated into Yoga and control groups. SBT was administered to COVID-positive patients. Both SBT and LBDT were administered to COVID-recovered patients and HCWs. A total of 18 biochemical parameters, a 6-min walk test (6MWT), and a 1-min sit-stand test (1MSST) were assessed on 0th, 7th, and 15th days, where biochemical parameters were the primary outcome. Pre-post estimation of neuropsychological parameters (nine questionnaires) and heart rate variability (HRV) were carried out. The paired t-test or Wilcoxon rank test was applied for pre-post comparison and the Student's t-test or Mann-Whitney U test was used for group comparison. Repeated measures test was applied for data recorded at three time points. Results: A significant elevation in white blood cell (WBC) count was observed in COVID-positive intervention (p < 0.001) and control groups (p = 0.003), indicating no role of intervention on change in WBC number. WBC count (p = 0.002) and D-dimer (p = 0.002) significantly decreased in the COVID-recovered intervention group. D-dimer was also reduced in HCWs practicing Yogic breathing as compared to controls (p = 0.01). D-dimer was the primary outcome, which remained below 0.50 µg/ml (a cutoff value to define severity) in the COVID-positive yoga group (CYG) and decreased in the COVID-recovered yoga group (RYG) and the HCW yoga group (HYG) after intervention. A 6-min walk test (6MWT) showed an increase in distance covered among the COVID-positive patients (p = 0.01) and HCWs (p = 0.002) after intervention. The high-frequency power (p = 0.01) was found to be reduced in the COVID-positive intervention group. No significant change in neuropsychological parameters was observed. Conclusion: Yogic breathing lowered D-dimer, which is helpful in reducing thrombosis and venous thromboembolism in patients with COVID-19 besides lowering the chances of vaccine-induced thrombotic thrombocytopenia in vaccinated individuals. The breathing intervention improved exercise capacity in mild to moderate cases of COVID-19. Further studies can show if such breathing techniques can influence immunity-related genes, as reported recently in a study. We suggest that Yogic breathing may be considered an integrative approach for the management of patients with COVID. Trial registration: http://ctri.nic.in/Clinicaltrials/login.php, identifier: CTRI/2020/10/028195.

Clinical analysis of 99 children with Henoch-Schönlein purpura complicated with overt gastrointestinal bleeding.

OBJECTIVE: To analyze and summarize the clinical features, diagnosis, and treatment of children with Henoch-Schönlein purpura (HSP) complicated by overt gastrointestinal bleeding (GI bleeding) for achieving early identification, prevention, and treatment in terms of severe GI bleeding. METHODS: A retrospective analysis was conducted on children with HSP complicated by overt GI bleeding who were admitted to the Department of Traditional Chinese Medicine of Beijing Children's Hospital from January 2017 to December 2019. According to the severity of GI bleeding, the patients were divided into mild bleeding group (61 cases) and moderate and severe bleeding group (38 cases). Inflammatory parameters, coagulation function, GI ultrasound findings, and clinical features were compared. Logistic regression analysis was used to determine the related variables affecting the severity of GI bleeding, and the ROC curve was used to determine the variable test efficacy. RESULTS: Onset in summer, wide distribution of skin rash with facial involvement, the elevation of D-dimer and high neutrophil-to-lymphocyte ratio (NLR) had significant effects on the severity of GI bleeding. ROC curve analysis showed that the optimal cut-off points of NLR and D-dimer for predicting severe GI bleeding in children with HSP were 10.56 and 0.89 mg/L, respectively. CONCLUSION: Facial rash may be a warning sign of GI bleeding. Enhanced monitoring of NLR and D-dimer is helpful for early recognition of GI bleeding as well as assessment of severity.

D-dimer Thresholds to Exclude Pulmonary Embolism among COVID-19 Patients in the Emergency Department: Derivation with Independent Validation.

OBJECTIVE: To derive and validate a D-dimer cutoff for ruling out pulmonary embolism (PE) in COVID-19 patients presenting to the emergency department (ED). METHODS: A retrospective cohort study was performed in an integrated healthcare system including 22 adult ED's between March 1, 2020, and January 31, 2021. Results were validated among patients enrolled in the RECOVER Registry, representing data from 154 ED's from 26 US states. Consecutive ED patients with laboratory confirmed COVID-19, a D-dimer performed within 48 h of ED arrival, and with objectively confirmed PE were compared to those without PE. After identifying a D-dimer threshold at which the 95% confidence lower bound of the negative predictive value for PE was higher than 98% in the derivation cohort, it was validated using RECOVER registry data. RESULTS: Among 3978 patients with a D-dimer result, 3583 with confirmed COVID-19 infection were included in the derivation cohort. Overall, PE incidence was 4.1% and a D-dimer cutoff of <2 µ/mL (2000 ng/mL) was associated with a NPV of 98.5% (95% CI = 98.0%-98.9%). In the validation cohort of 13,091 patients with a D-dimer, 7748 had confirmed COVID-19 infection, and the PE incidence was 1.14%. A D-dimer cutoff of <2 µ/mL was associated with a NPV of 99.5% (95% CI = 99.3%-99.7%). CONCLUSION: A D-dimer cutoff of <2 µ/ml was associated with a high negative predictive value for PE among patients with COVID-19. However, the resultant sensitivity for PE result at that threshold without pre-test probability assessment would be considered clinically unsafe.

A case series sharing novel experience of treating viral pandemic cases of morbid, mid aged, mild, moderate & severe grade with only Ayurvedic Medicines.

In ongoing viral pandemic named as COVID-19 also Severe Acute Respiratory illness (SARI) or Flue Like illness (FLI) reported surging in many cities of India and many of the patients opted for traditional medicine, in spite of they have been given a option of contemporary line of treatment instructed by health authorities, they opted to take traditional indian medicine that is Ayurvedic medicine. Present case series is a same novel experience of early diagnosing and treating mid aged, morbid individuals who took only Ayurvedic treatment and could get out of the disease without any complications. This case series had 10 mid aged, morbid patients with maximum symptoms of COVID-19 disease and their hemogram and CRP was suggestive of moderate to severe type COVID-19/FLI/SARI. They were diagnosed by contemporary methods of pathology and treated with Ayurvedic classical medicines Tamra Sinduradi Yoga and Bhunimbadi Kwath for 20 days along with continuing the medicines for their ongoing morbidities. All 10 patients showed recoveries without any complications, they reduced their all symptoms, drastic reduction in their CRP and corrections in their hemograms were observed and also they showed any complications neither physically nor in their pathological tests. Hence it can be concluded that early diagnosis and treating it with Ayurvedic medicine can manage viral pandemic issue in a very successful way.

Beneficial effects of novel aureobasidium pullulans strains produced beta-1,3-1,6 glucans on interleukin-6 and D-dimer levels in COVID-19 patients; results of a randomized multiple-arm pilot clinical study.

OBJECTIVE: In this pilot clinical study, we report the beneficial effects of beta glucans derived from two strains AFO-202 and N-163 of a black yeast Aureobasidium pullulans on the biomarkers for cytokine storm and coagulopathy in COVID-19 patients. METHODS: A total of 24 RT-PCR positive COVID-19 patients were recruited and randomly divided into three groups (Gr): Gr. 1 control (n = 8) - Standard treatment; Gr. 2: Standard treatment + AFO-202 beta glucan (n = 8); and Gr. 3, Standard treatment + combination of AFO-202 and N-163 beta glucans (n = 8) for 30 days. RESULTS: There was no mortality or requirement of ventilation of the subjects in any of the groups. There was a decrease in D-Dimer values (751 ng/ml to 143.89 ng/ml) and IL-6 values (7.395-3.16 pg/ml) in Gr. 1 in 15 days but the levels increased to abnormal levels on day 30 (D-Dimer: 202.5 ng/ml; IL-6 55.37 pg/ml); which steadily decreased up to day 30 in groups 2 (D-dimer: 560.99 ng/dl to 79.615; IL-6: 26.18-3.41 pg/ml) and 3 (D-dimer: 1614 ng/dl to 164.25 ng/dl; IL-6: 6.25-0.5 pg/ml). The same trend was observed with ESR. LCR and LeCR increased while NLR decreased significantly in Gr. 3. CD4 + and CD8 + T cell count showed relatively higher increase in Gr.3. There was no difference in CRP within the groups. CONCLUSION: As these beta glucans are well known food supplements with a track record for safety, larger multi-centric clinical studies are recommended to validate their use as an adjunct in the management of COVID-19 and the ensuing long COVID-19 syndrome.

Colchicine, COVID-19 and hematological parameters: A meta-analysis.

INTRODUCTION: Colchicine has the potential in reducing patient morbidity and mortality in COVID-19 infection owing to its anti-inflammatory properties. This study aims to determine the efficacy of colchicine in optimizing inflammatory hematological biomarker levels among COVID-19 patients. METHODS: In accordance to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement guidelines, a systematic search was conducted using the following keywords: Colchicine, covid*, SARS-CoV-2, anti-inflammatory, trials, clinical, hematological, laboratory. Databases were searched from December 2019 until August 26, 2021: MEDLINE/PubMed, Web of Science, Cochrane, Scopus, and EMBASE. Other sources were located through ClinicalTrials.Gov, manually searching SAGE, Science Direct, Elsevier, and Google Scholar. The meta-analysis was conducted using Review Manager 5.4. RESULTS: In total, six studies were included, of which four reported c-reactive protein (CRP) standardized mean reductions in the colchicine group (N = 165) as opposed to the control (N = 252; SMD = -0.49, p < 0.001). On noting lactate dehydrogenase (LDH) values post treatment, the colchicine group (N = 204) showed significant reductions at the end of treatment compared to control (N = 290; SMD = -0.85, p < 0.001). Finally, the D-dimer values in colchicine groups (N = 129) compared to control (N = 216) also documented a negative effect size (SMD = -0.9, p < 0.001). CONCLUSION: Colchicine has efficacy in reducing inflammatory biomarkers observed in moderate-to-severe COVID-19 patients. It may be worthwhile to consider monitoring the clinical and laboratory parameters of patients in further trials to consider colchicine as a strong candidate for an adjunct to COVID-19 treatment.

[Preliminary study of the changes in blood system in pyrrolizidine alkaloid-related liver damage].

Objective: To preliminary explore the changes in blood system in pyrrolizidine alkaloids (PAs)-related liver damage. Methods: General situation, liver function, biochemical blood test, routine blood test, coagulation function markers, etc., of 77 cases with drug-induced liver damage admitted to the Zhongshan Hospital Affiliated to Fudan University from 2012 to 2019 were retrospectively analyzed. Patients' were divided into PA group, other traditional Chinese medicine group and Western medicine group according to their medication history. Simultaneously, the changes in liver function were observed in the established mice model of monocrotaline-induced liver damage. Liver tissues HE staining and blood routine indexes were observed. Results: 24 cases received PA, 24 cases received other traditional Chinese medicine, and 29 cases received western medicine. Alanine aminotransferase was lower in PA group than the other two groups (P < 0.05), and the total bilirubin and direct bilirubin were significantly lower than the other traditional Chinese medicine group (P < 0.05). The peripheral platelet count of the PA group was (84.11 ± 26.91) ×10(9)/L, which was significantly lower than the lower limit of normal, and had statistically significant difference with other traditional Chinese medicine and western medicine group (P < 0.01). Thrombocytocrit, mean platelet volume and platelet indices of PA group were statistically different from the other two groups (P < 0.05). The D-dimer level in patients with PA group was (2.62 ± 1.93) mg/L, which was higher than the upper limit of normal, and significantly higher than the D-dimer level of the other two groups of patients (P < 0.01). Meanwhile, prothrombin time was longer in PA group than that of the other two groups (P < 0.01), and platelets count were decreased significantly in the mouse model of monocrotaline-induced liver damage after alanine aminotransferase and aspartate aminotransferase elevation (P < 0.01). Conclusion: PA-related liver damage has lower peripheral platelet counts, and the peripheral platelet counts of these patients are lower than other types of drug-induced liver damage. In addition, increased D-dimer in patients with PA-related liver damage indicate a potential risk of thrombosis.

Dietary Supplementation with Selenium and Coenzyme Q10 Prevents Increase in Plasma D-Dimer While Lowering Cardiovascular Mortality in an Elderly Swedish Population.

A low intake of selenium is associated with increased cardiovascular mortality. This could be reduced by supplementation with selenium and coenzyme Q10. D-dimer, a fragment of fibrin mirroring fibrinolysis, is a biomarker of thromboembolism, increased inflammation, endothelial dysfunction and is associated with cardiovascular mortality in ischemic heart disease. The objective was to examine the impact of selenium and coenzyme Q10 on the level of D-dimer, and its relationship to cardiovascular mortality. D-dimer was measured in 213 individuals at the start and after 48 months of a randomised double-blind placebo-controlled trial with selenium yeast (200 µg/day) and coenzyme Q10 (200 mg/day) (n = 106) or placebo (n = 107). The follow-up time was 4.9 years. All included individuals were low in selenium (mean 67 µg/L, SD 16.8). The differences in D-dimer concentration were evaluated by the use of T-tests, repeated measures of variance and ANCOVA analyses. At the end, a significantly lower D-dimer concentration was observed in the active treatment group in comparison with those on placebo (p = 0.006). Although D-dimer values at baseline were weakly associated with high-sensitive CRP, while being more strongly associated with soluble tumour necrosis factor receptor 1 and sP-selectin, controlling for these in the analysis there was an independent effect on D-dimer. In participants with a D-dimer level above median at baseline, the supplementation resulted in significantly lower cardiovascular mortality compared to those on placebo (p = 0.014). All results were validated with a persisting significant difference between the two groups. Therefore, supplementation with selenium and coenzyme Q10 in a group of elderly low in selenium and coenzyme Q10 prevented an increase in D-dimer and reduced the risk of cardiovascular mortality in comparison with the placebo group. The obtained results also illustrate important associations between inflammation, endothelial function and cardiovascular risk.

The relationship between vitamin D and the severity of COVID-19.

AIM: Vitamin D, which has immunomodulatory effect, can reduce risk of infections and concentrations of pro-inflammatory cytokines. The aim of this study was to investigate the relationship between the levels of vitamin D and severity of COVID-19. METHODS: A total of 204 patients with COVID-19 disease were enrolled in the study. All patients had viral pneumonia, which was confirmed with chest computer tomography. All cases were divided in two groups- mild (outpatients); and serious (inpatients)- according to their clinical and laboratory data. Serum vitamin D levels were measured by chemiluminescence method. RESULTS: Vitamin D deficiency was found in 41.7 % (n = 85) of cases and insufficiency was found in 46.0 % (n = 94), while in 12.3 % (n = 25) of cases normal vitamin D levels were found. The odds of having a serious clinical outcome were increased for vitamin D insufficiency patients 5.604 times (%95 CI:0.633-49.584) and for vitamin D deficiency patients 38.095 times (%95 CI:2.965-489.50) for each standard deviation decrease in serum 25(OH)D. CONCLUSION: Adequate levels of vitamin D could suppress inflammation and reduce the severity of COVID-19. Vitamin D supplementation may have an important role in decreasing the impact of the pandemic (Tab. 5, Fig. 2, Ref. 27).

High pretreatment plasma D-dimer levels predict poor survival in patients with diffuse large B-cell lymphoma in the real world.

BACKGROUND: Data on the role of pretreatment plasma D-dimer levels in the prognostic prediction of patients with diffuse large B-cell lymphoma (DLBCL) are limited. We here studied the potential prognostic roles of pretreatment plasma D-dimer levels in patients with DLBCL. METHODS: We retrospectively analyzed medical records of 308 newly diagnosed patients with DLBCL admitted to the Fujian Medical University Union Hospital between January 2011 and December 2018. Receiver operating characteristic (ROC) curve analysis were used to generate an optimal cut-off value for pretreatment plasma D-dimer levels in patients with DLBCL. According to the cut-off value, all patients were divided into the low D-dimer and high D-dimer groups. We analyzed the relationship between pretreatment plasma D-dimer levels and clinical and laboratory characteristics in patients with DLBCL. Univariate and multivariate analyses were used to assess prognostic factors for overall survival (OS) and progression-free survival (PFS). RESULTS: Patients with B symptoms, plasma lactate dehydrogenase levels >upper limit of normal (ULN), poor Eastern Cooperative Oncology Group score (2 to 4), advanced stage (III-IV), >1 extranodal site, higher International Prognostic Index (IPI) (2 to 5) and higher National Comprehensive Cancer Network IPI (NCCN-IPI) (≥4) (all P<0.001) had higher pretreatment plasma D-dimer levels (≥1.4 µg/mL). Patients with higher plasma D-dimer levels had worse OS and PFS (P<0.001 and P=0.001, respectively). CONCLUSIONS: Higher pretreatment plasma D-dimer level was associated with poor survival and was an independent poor predictor of OS among untreated patients with DLBCL.

Changes in alkaline phosphatase, calcium, C-reactive protein, D-dimer, phosphorus and hemoglobin in elderly osteoporotic hip fracture patients.

BACKGROUND: This study aims to evaluate the association between serum alkaline phosphatase (ALP), calcium (Ca) and phosphorus (P), C-reactive protein (CRP) and D-dimer (D-D), and hemoglobin (Hb) in postoperative and preoperative osteoporotic hip fracture elderly patients. METHODS: A total of 32 operation patients with osteoporotic hip fracture over the age of 65 years old were admitted to the orthopedic unit and prospectively evaluated. All patients were treated according to specific protocols, according to the type of fracture. Fasting blood samples were taken, and serum ALP, Ca and P measurements were respectively performed in six periods: at the time of admission, post-operation, and at postoperative one week, two weeks, one month and three months. Hb, CRP and D-D were also analyzed, and the fracture healing was recorded. RESULTS: Finally, 32 cases were selected for the present study. The analysis results revealed that the level of serum Ca and ALP slowly increased at two weeks after surgery, and slightly dropped back at three months after the operation. Furthermore, D-D and CRP had a significant effect at pre- and post-operation, and exhibited an obvious downward trend after postoperative one week. The fracture healing and recovery of activities were associated with the Hb levels. The serum levels of ALP, which were adjusted by Ca and P, were associated with Hb and CRP, but not with D-D. CONCLUSIONS: Interestingly, there was an association between CRP and D-D. These findings suggest that early control of inflammation and loss of Ca could play a positive role for the healing of osteoporotic hip fractures.

Oxygen-ozone (O2-O3) immunoceutical therapy for patients with COVID-19. Preliminary evidence reported.

OBJECTIVE: This study evaluated the potential efficacy of a novel approach to treat COVID-19 patients, using an oxygen-ozone (O2-O3) mixture, via a process called Oxygen-Ozone- Immunoceutical Therapy. The methodology met the criteria of a novel, promising approach to treat successfully elderly COVID-19 patients, particularly when hospitalized in intensive care units (ICUs) Experimental design: We investigated the therapeutic effect of 4 cycles of O2-O3 in 50 hospitalized COVID-19 subjects suffering from acute respiratory disease syndrome (ARDS), aged more than 60 years, all males and undergoing non invasive mechanical ventilation in ICUs. RESULTS: Following O2-O3 treatment a significant improvement in inflammation and oxygenation indexes occurred rapidly and within the first 9 days after the treatment, despite the expected 14-20 days. A significant reduction of inflammatory and thromboembolic markers (CRP, IL-6, D-dimer) was observed. Furthermore, amelioration in the major respiratory indexes, such as respiratory and gas exchange markers (SatO2%, PaO2/FiO2 ratio), was reported. CONCLUSION: Our results show that O2-O3 treatment would be a promising therapy for COVID-19 patients. It leads patients to a fast recovery from ARDS via the improvement of major respiratory indexes and blood gas parameters, following a relatively short time of dispensed forced ventilation (about one to two weeks). This study may encourage the scientific community to further investigate and evaluate the proposed method for the treatment of COVID-19 patients.

Clinical Observations on Combined Use of Acupuncture and Medicine for Lower-limb Deep Venous Thrombosis / 上海针灸杂志

Objective To investigate the efficacy of acupuncture and moxibustion plus modern medication for lower-limb deep venous thrombosis. Method Ninety patients with lower-limb deep venous thrombosis were allocated, using a random number table, to control and observation groups. The control group received anticoagulant, thrombolytic and volume expansion therapy and the observation group, acupuncture and moxibustion in addition.Hemorheological indicators, D-dimer concentration and lower-limb venous blood flow velocity were measured before and after treatment. Result There were statistically significant pre/post-treatment differences in whole blood viscosity and platelet aggregation rate in the control group of patients after treatment (P<0.05). There were statistically significant pre/post-treatment differences in whole blood viscosity, plasma viscosity, hematocrit, erythrocyte electrodeposition rate and platelet aggregation rate in the observation group of patients after treatment (P<0.05). After treatment, there were statistically significant differences in whole blood viscosity, plasma viscosity, hematocrit, erythrocyte electrodeposition rate and platelet aggregation rate between the observation and control groups of patients (P<0.05). D-dimer concentration was lower in the control group of patients at the end of 10 and 20 days of treatment compared with before with astatistically significant difference (P<0.05). D-dimer concentration was lower in the observation group of patients at the end of 5, 10 and 20 days of treatment compared with before with a statistically significant difference (P<0.05). At the end of 5, 10 and 20 days of treatment, D-dimer concentration was lower in the observation group than in the control group with a statistically significant difference (P<0.05). At the end of treatment, there was a statistically significant pre-/post-treatment difference in color Doppler-visualized lower-limb blood flow velocity in both groups of patients (P<0.05). At the end of treatment, lower-limb blood flow velocity was higher in the observation group of patients than in the control group with a statistically significant difference (P<0.05). After treatment, the total efficacy rate was markedly higher in the observation group of patients than in the control group with a statistically significant difference (P<0.05). Conclusion Acupuncture and moxibustion plus modern medication is significantly more effective than medication alone in treating lower-limb deep venous thrombosis.

Analysis of the results of D-dimer and coagulation indicators in pregnant patients with hypertensive disorder / 中国基层医药

Objective@#To analyze the clinical test results of D-dimer and coagulation indicators in pregnant patients with hypertensive disorder, and to explore the diagnostic value of D-dimer and coagulation index.@*Methods@#From January 2016 to December 2017, 50 pregnant women with hypertensive disorder (observation group) and 50 healthy pregnant women(control group) who underwent antenatal examination in the Traditional Chinese Medicine Hospital of Yiwu were selected.The plasma D-dimer, coagulation parameters (prothrombin time, activated partial thromboplastin time, thrombin time) were compared between the two groups.According to the condition of hypertensive disorder complicating pregnancy, the observation group was divided into three subgroups: simple gestational hypertension group, mild preeclampsia group and severe preeclampsia group.Pearson correlation coefficient analysis was used to analyze the correlation between plasma D-dimer, coagulation parameters and hypertensive disorder complicating pregnancy.@*Results@#In the observation group, the D-dimer level[(413.15±127.62)μg/L] was higher than that in the control group[(284.29±97.86)μg/L](t=5.666, P<0.05). The prothrombin time[(10.12±1.07)s], activated partial thrombin time[(25.16±3.32)s], and thrombin time[(20.87±2.52)s] in the observation group were all shorter than those in the control group[(12.54±1.93)s, (31.84±5.87)s, (24.26±3.27)s](t=7.754, 7.004, 5.806, all P<0.05). The differences of D-dimer level, prothrombin time, activated partial thrombin time and thrombin time among the simple gestational hypertension group, mild preeclampsia group and severe preeclampsia group were statistically significant(F=4.710, 4.297, 4.411, 4.979, all P<0.05). The level of D-dimer was positively correlated with hypertensive disorder complicating pregnancy(r=0.725), while prothrombin time, activated partial thromboplastin time and thrombin time were negatively correlated with hypertensive disorder during pregnancy(r=-0.713, -0.704, -0.719).@*Conclusion@#The blood of patients with hypertensive disorder complicating pregnancy is generally in hypercoagulable state of D-dimer.The detection of coagulation index can be used as an auxiliary diagnostic index for hypertensive disorder complicating pregnancy.

Analysis of the results of D-dimer and coagulation indicators in pregnant patients with hypertensive disorder / 中国基层医药

Objective To analyze the clinical test results of D-dimer and coagulation indicators in pregnant patients with hypertensive disorder , and to explore the diagnostic value of D-dimer and coagulation index. Methods From January 2016 to December 2017,50 pregnant women with hypertensive disorder (observation group) and 50 healthy pregnant women ( control group ) who underwent antenatal examination in the Traditional Chinese Medicine Hospital of Yiwu were selected.The plasma D-dimer,coagulation parameters (prothrombin time,activated partial thromboplastin time ,thrombin time) were compared between the two groups.According to the condition of hypertensive disorder complicating pregnancy , the observation group was divided into three subgroups : simple gestational hypertension group,mild preeclampsia group and severe preeclampsia group.Pearson correlation coefficient analysis was used to analyze the correlation between plasma D-dimer, coagulation parameters and hypertensive disorder complicating pregnancy.Results In the observation group ,the D-dimer level[(413.15 ±127.62)μg／L] was higher than that in the control group [(284.29 ±97.86) μg／L] ( t＝5.666,P＜0.05).The prothrombin time [(10.12 ±1.07)s],activated partial thrombin time [(25.16 ±3.32) s],and thrombin time [(20.87 ±2.52) s] in the observation group were all shorter than those in the control group [(12.54 ±1.93)s,(31.84 ±5.87)s,(24.26 ± 3.27)s] (t＝7.754,7.004,5.806,all P＜0.05).The differences of D-dimer level,prothrombin time,activated partial thrombin time and thrombin time among the simple gestational hypertension group ,mild preeclampsia group and severe preeclampsia group were statistically significant (F＝4.710,4.297,4.411,4.979,all P＜0.05).The level of D-dimer was positively correlated with hypertensive disorder complicating pregnancy (r＝0.725),while prothrom-bin time,activated partial thromboplastin time and thrombin time were negatively correlated with hypertensive disorder during pregnancy(r＝-0.713,-0.704,-0.719).Conclusion The blood of patients with hypertensive disorder complicating pregnancy is generally in hypercoagulable state of D-dimer.The detection of coagulation index can be used as an auxiliary diagnostic index for hypertensive disorder complicating pregnancy .

Changes in concentrations of haemostatic and inflammatory biomarkers in synovial fluid after intra-articular injection of lipopolysaccharide in horses.

BACKGROUND: Septic arthritis is a common and potentially devastating disease characterized by severe intra-articular (IA) inflammation and fibrin deposition. Research into equine joint pathologies has focused on inflammation, but recent research in humans suggests that both haemostatic and inflammatory pathways are activated in the joint compartment in arthritic conditions. The aim of this study was to characterize the IA haemostatic and inflammatory responses in horses with experimental lipopolysaccharide (LPS)-induced joint inflammation. Inflammation was induced by IA injection of LPS into one antebrachiocarpal joint of six horses. Horses were evaluated clinically with subjective grading of lameness, and blood and synovial fluid (SF) samples were collected at post injection hours (PIH) -120, -96, -24, 0, 2, 4, 8, 16, 24, 36, 48, 72 and 144. Total protein (TP), white blood cell counts (WBC), serum amyloid A (SAA), haptoglobin, iron, fibrinogen, thrombin-antithrombin (TAT) and d-dimer concentrations were assessed in blood and SF. RESULTS: Intra-articular injection of LPS caused local and systemic signs of inflammation including increased rectal temperature, lameness and increased joint circumference and skin temperature. Most of the biomarkers (TP, WBC, haptoglobin, fibrinogen and TAT) measured in SF increased quickly after LPS injection (at PIH 2-4), whereas SAA and d-dimer levels increased more slowly (at PIH 16 and 144, respectively). SF iron concentrations did not change statistically significantly. Blood WBC, SAA, haptoglobin and fibrinogen increased and iron decreased significantly in response to the IA LPS injection, while TAT and d-dimer concentrations did not change. Repeated pre-injection arthrocenteses caused significant changes in SF concentrations of TP, WBC and haptoglobin. CONCLUSION: Similar to inflammatory joint disease in humans, joint inflammation in horses was accompanied by an IA haemostatic response with changes in fibrinogen, TAT and d-dimer concentrations. Inflammatory and haemostatic responses were induced simultaneously and may likely interact. Further studies of interactions between the two responses are needed for a better understanding of pathogenesis of joint disease in horses. Knowledge of effects of repeated arthrocenteses on levels of SF biomarkers may be of value when markers are used for diagnostic purposes.

Treatment of 40 cases of atrial fibrillation by phlegm and blood stasis / 中国生化药物杂志

Objective To evaluate the effect of phlegm and blood stasis on atrial fibrillation and the effect of D-dimer on coagulation index. Methods 80 patients with phlegm and blood stasis were randomly divided into control group and treatment group, 40 cases in each group. The control group using a simple Western medicine treatment methods to Western medicine treatment based; and integrated traditional Chinese and Western medicine treatment group is based on Western medicine treatment, according to the traditional Chinese medicine syndrome, plus traditional Chinese medicine treatment, with Gualou Xiebai Banxia Decoction , Huanglian Wendan Decoction, Xuefu Zhuyu Decoction and other main plus or minus treatment, compared the two groups of efficacy, coagulation index (D-dimer). Results The total effective rate (97.5％) in the treatment group was higher than that in the control group (82.5％), the difference was statistically significant (P <0.05). After treatment, the level of D dimer in the treatment group was significantly lower than that in the control group, the difference was statistically significant (P <0.05). Conclusion The combination of traditional Chinese medicine and western medicine in the treatment of phlegm and blood stasis type is effective, and the level of D-dimer can be reduced.