Coagulation abnormalities and their relationship with bleeding manifestations in patients with dengue-A single center observational study

Objective:To evaluate coagulation abnormalities and their relationship with bleeding manifestations among patients with dengue.Methods:This observational study was conducted on 292 adult dengue patients who were admitted to a tertiary care hospital of Western India from July 2021 to June 2022.Coagulation tests including prothrombin time(PT),international normalized ratio(INR),activated partial thromboplastin time(aPTT),fibrinogen,and D-dimer were performed.Patients were monitored for bleeding manifestations.Results:Coagulation abnormalities were reported in 42.8%of the patients.Overall,prolonged aPTT was the most common coagulation abnormality(40.8%),followed by low fibrinogen(38.7%),raised D-dimer(31.2%),raised INR(26.0%)and prolonged PT(19.2%).Bleeding manifestations were present in 19.9%patients.PT,INR,aPTT and D-dimer levels were significantly higher(P<0.01)and fibrinogen level was significantly lower(P<0.001)in patients with bleeding compared to patients without bleeding.Patients with bleeding had a significantly higher rate of all coagulation abnormalities than patients without bleeding(P<0.01).Conclusions:Patients with bleeding showed a significantly higher frequency of coagulation abnormalities compared to patients without bleeding.Patients with dengue should be assessed for coagulation abnormalities.

Effects of exercise on leukocytosis and blood hemostasis in 800 healthy young females and males

AIM: To investigate the effects of exercise on healthy individuals of both genders. METHODS: This study lasted 6 years and involved about 800 healthy people. Individuals were divided into females and males and further sub-divided into two groups; in the first group individuals run(or skied in the winter time) and then rested for 3 h, whereas individuals in the second group intensely cycled for 5 min. The status of health was determined by measuring the sedimentation rate and the intensity of exercises by measuring the heart rate. Blood samples were collected before and after exercise. RESULTS: We observed that in the first group a significant increase of the total white blood cells, segmented neutrophils, band neutrophils, eosinophils and to a lesser extent lymphocytes but not monocytes in the blood circulation. However, all cell types were increased in the circulation after 5 min intense exercise. No differences in the pattern of cell increase were observed among the genders. Activated partial thromboplastin time(APTT) and D-dimer were also measured in the blood of individuals who cycled intensely for 5 min to determine the coagulation and fibrinolytic activities in the blood. APTT is reduced and D-dimer values significantly increased after intense exercise. However, APTT was statistically lower in males than females, whereas no differences in the D-dimer values were observed among the genders. CONCLUSION: Our results indicate that exercise whether leisure or strenuous affects leukocytosis and hemostasis in both genders. A major advantage of this study is the high numbers of individuals involved and the inclusion of both females and males values.

Thromboelastography: Current Applications, Future Directions

Analyzing coagulability often hinges on patient surveillance using prothrombin time (PT) or international normalized ratio (INR) and activated partial thromboplastin time (aPTT) to monitor the extrinsic and intrinsic coagulation pathways, respectively A more complete assessment, however, can often be obtained using thromboelastography (TEG), a coagulation assay that evaluates the efficiency of clot formation, as well as the viscoelastic properties of the clot. Developed by Dr. Helmut Hartert in 1948 at the UniversityofHeidelberg, it provides information regarding hemostasis as a dynamic process [1,2]. Here, the TEG technique will be described, as well as its current applications and future directions for its use.

COAGULATION ACTIVITY IN VARIOUS STRAINS OF YOSHIDA ASCITES HEPATOMA TISSUES AND CELLS OF RAT

To investigate the mechanism of chemotherapy related DIC, a quantitative and comparative study was carried out on the coagulation activities of tumor cells and tumor tissues in three strains of rat ascites hepatoma AH109A, AH272 and LY80. The content of thrombo-plastin was expressed as the relative concentration against that in the brain tissue. Ascites hepatoma cell and tissue of each strain obviously have different quantities of coagulants, such as tissue thromboplastin. Coagulation activities of tumor tissues are higher than that of tumor cells. The coagulation activities of tumor tissues and cells of AH272 were higher than that of AH109A and LY80. Our findings suggest that the initiation of DIC not only depend on the tissue thromboplastin, the other factors or the other mechanisms should be considered.

Clinical association between coagulation indicators and bone metastasis in patients with gastric cancer

BACKGROUND Bones are one of the most common target organs for cancer metastasis.Early evaluation of bone metastasis(BM)status is clinically significant.Cancer patients often experience a hypercoagulable state.AIM To evaluate the correlation between coagulation indicators and the burden of BM in gastric cancer(GC).METHODS We conducted a single-center retrospective study and enrolled 454 patients.Clinical information including routine blood examination and coagulation markers were collected before any treatment.Patients were grouped according to the status of BM.Receiver operating characteristic curves were used to assess diagnostic performance and determine the optimal cutoff values of the above indicators.Cutoff values,sensitivity and specificity were based on the maximum Youden index.Univariate and multivariate logistic regression analyses were used to evaluate the relationships between biomarkers and BM.RESULTS Of the 454 enrolled patients,191 patients were diagnosed with BM.The receiver operating characteristic curve analysis suggested that prothrombin time(PT)Wang X et al.Coagulation indicators predict bone metastasis WJGO https://www.wjgnet.com 1254 July 15,2023 Volume 15 Issue 7[cutoff:13.25;sensitivity:0.651;specificity:0.709;area under receiver operating characteristic curve(AUC)=0.738],activated partial thromboplastin time(aPTT)(cutoff:35.15;sensitivity:0.640;specificity:0.640;AUC=0.678)and fibrin degradation products(FDP)(cutoff:2.75;sensitivity:0.668;specificity:0.801;AUC=0.768)act as novel predictors for BM.Based on multivariate logistic regression analysis,the results showed the independent correlation between PT[odds ratio(OR):3.16;95%confidence interval(CI):1.612-6.194;P=0.001],aPTT(OR:2.234;95%CI:1.157-4.313;P=0.017)and FDP(OR:3.17;95%CI:1.637-6.139;P=0.001)and BM in patients with GC.Moreover,age,carcinoembryonic antigen,erythrocyte and globulin were found to be significantly associated with BM.CONCLUSION Coagulation markers,namely PT,aPTT and FDP,might be potential predictors for screening BM in patients with GC.

Effects of Chloroquine and Naphthoquinone on Prothrombin Time and Activated Partial Thromboplastin Time of Swiss Mice

Concerns on the coagulation variables, Prothrombin Time (PT) and Activated Partial Thromboplastin Time (APTT) which are part of coagulation parameters used in assessing haemostatsis in haematology, led to the study of the effects of naphthoquinone and chloroquine on the PT and APTT of mice infected with Plasmodium berghei, and treated with graded concentrations of chloroquine and naphthoquinone. Using brain thromboplastin with calcium and rabbit brain cephalosporin ad kaolin respectively the experiment aimed at demonstrating the effect of chloroquine with purity of 99.79% and naphthoquinone with purity of 97.00%, upon a three-day intraperitoneal administration at concentrations of 0.1 mg/kg, 0.5 mg/kg, 1.0 mg/kg and 2.0 mg/kg. Result showed that the APTT and PT of naphthoquinone at 2.0 mg/kg, were 196.67 seconds, and 67.63 seconds respectively, while the APTT and PT of chloroquine were 3.63 seconds and 1.40 seconds respectively for the same concentration. Also, naphthoquinone showed lower APTT but sustained PT at concentrations below 1.50 mg/kg whereas both APTT and PT increased from concentrations above 1.50 mg/kg. On the other hand chloroquine showed a lowered APTT between 0.00 to 0.15 mg/kg while PT was sustained, but both APTT and PT increased from concentration of 0.15 mg/kg gradually. This study conclusively showed that chloroquine has a shorter APTT and PT than naphthoquinones, even though they elicited similar actions. Apart from this, naphthoquinone and chloroquine belonging to the same family, naphthoquinone could be more toxic than chloroquine at the dosages equivalent to 1.50 mg/kg, therefore, any administration of naphthoquinone above this dosage should be closely monitored to avoid any form of danger to the patient.

Laboratory Tests in Assessing the Bleeding Risk in Patients Receiving Direct Oral Anticoagulants (DOACs)

Direct oral anticoagulants (DOACs)—apixaban, rivaroxaban and dabigatran have become the first line medications for patients with thromboembolism. However, DOAC therapy-associated bleeding complications remain the major clinical concern for these patients.?This study compared laboratory test results from 82 patients with and 361 patients without DOAC-associated bleeding with the goal of determining the value of laboratory tests in assessing bleeding risk in these patients.?There was no age or gender difference between patients with and without DOAC therapy-associated bleeding complications. Both prothrombin time?(PT) and partial thromboplastin time (PTT) prolonged at the same time showed good correlation with bleeding complications for patients receiving dabigatran (91.7%) and rivaroxaban (41.2%). When comparing patients with bleeding and those without bleeding complications, impaired renal function showed high correlation (p??0.01),?impaired liver function?showed moderate correlation (p?=?0.03), and thrombocytopenia showed no correlation (p?>?0.05)?among patients with bleeding complications.?A small population of patients had never experienced bleeding complications, despite thelaboratory test results being similar to patients?who suffered?from bleeding complications. Laboratory tests may be useful in the assessment and prediction of bleeding complications in patients receiving DOAC therapy. However, it is important to incorporate both laboratory findings with the clinical information, such as concomitant antithrombotic agents and other underlying diseases in the decision making of DOAC therapy in order to reduce therapy-related bleeding risk.

Relevant detection indicator of prethrombotic state in patients with primary hypertension

BACKGROUND Hypertension is a common chronic disease that affects many people worldwide.Only a few reports related to the exploration of relevant indicators of the prethrombotic state in patients with primary hypertension(PH)in clinical settings were available.AIM To detect prethrombotic state-related indicators in patients with PH and analyze their differences in different patient populations to provide a laboratory basis for the clinical prevention and control of hypertensive thrombotic diseases.METHODS The general data of patients with PH who attended the Department of Cardiovascular Medicine,The First Affiliated Hospital of Jiangxi Medical College,from January 2022 to December 2022 were collected retrospectively.The patients were divided into three groups of 40 patients each according to the Grade of PH:Grade 1,Grade 2,and Grade 3 hypertension experimental group.The baseline data of 40 volunteers,who underwent physical examination in our hospital but were not diagnosed with PH during the same period,were included in the control group.The relevant indicators of prethrombotic state of the participants were compared,and mainly included inflammation-related indicators,hemorheology-related indicators,and coagulation function related indicators.The relationship between the aforementioned indicators and the progression of PH was analyzed.RESULTS No significant differences were observed in age,sex,diabetes mellitus,smoking history,drinking history,body mass index,New York Heart Association functional classification,or the course of hypertension among the four groups(P>0.05).The expressions of high-sensitivity C-reactive protein(hs-CRP),thrombomodulin(TM),hematocrit(Hct),erythrocyte sedimentation rate(ESR),P-selectin on platelet surface(CD62P),and fibrinogen(FIB)in the control group were<Grade 1 hypertension group<Grade 2 hypertension group<Grade 3 hypertension group,and the expressions of platelet(PLT),activated partial thromboplastin time(APTT),prothrombin(PT),and plasma thrombin time(TT)in the control group was>Grade 1 hypertension group>Grade 2 hypertension group>Grade 3 hypertension group,and the difference was statistically significant(P<0.05).The results of the multivariate logistic regression model showed that the expression of hs-CRP,TM,Hct,ESR,CD62P,PLT,APTT,PT,TT,and FIB in the included participants was related to the progression of PH.Among these,high expression of hs-CRP,TM,Hct,ESR,CD62P,APTT,PT,and TT,and low expression of PLT and FIB were risk factors for PH(OR>1,P<0.05).The results of the receiver operating characteristic curve analysis showed that the area under the curve of hs-CRP,TM,ESR,CD62P,APTT,PT,TT,and FIB for the prediction of PH were>0.80,and the prediction value was ideal.Linear correlation analysis with bivariate Spearman showed that hs-CRP,TM,Hct,ESR,CD62P,APTT,PT,and TT were positively correlated with each other(r>0,P<0.05);PLT and FIB were negatively correlated with hs-CRP,TM,Hct,ESR,CD62P,APTT,PT,and TT(r<0,P<0.05);and PLT and FIB were positively correlated(r>0,P<0.05).Linear correlation analysis using bivariate Spearman showed that hs-CRP,TM,Hct,ESR,CD62P,and FIB were positively correlated with each other(r>0,P<0.05),whereas PLT,APTT,PT,and TT were negatively correlated with hs-CRP,TM,Hct,ESR,CD62P,and FIB(r<0,P<0.05).There was a positive correlation between PLT,APTT,PT,and TT(r>0,P<0.05).CONCLUSION The relevant indicators of the prethrombotic state in patients with PH,such as hs-CRP,TM,Hct,ESR,CD62P,PLT,APTT,PT,TT,and FIB,showed differences.High expression of hs-CRP,TM,Hct,ESR,CD62P,and FIB,and low expression of PLT,APTT,PT,and TT are the keys to the occurrence,progression,and thrombotic state of PH.Based on the above serum indicators’expression in patients,targeted interventions can be administered to patients with abnormal expression levels to control the progression of their disease and reduce the risk of developing a prethrombotic state.

Factor XII (Hageman Factor) Deficiency: A Very Rare Coagulation Disorder

Background: Factor XII (Hageman Factor) is the initiating factor for the Intrinsic Pathway of Coagulation. Very low levels of Factor XII have been associated with increased levels of activated Partial Thromboplastin Time (aPTT). Association of Factor XII deficiency is more with thromboembolic disorders rather than bleeding tendencies. Aim: To learn more about the relationship of factor XII (Hageman Factor) deficiency and high levels of activated Partial Thromboplastin Time. Case Presentation: The Patient was admitted with complains of recurrent headaches and loin pain. Patient was incidentally found to have prolonged activated Partial Thromboplastin Time. This led to investigations which ultimately provided the evidence of severely low levels of Hageman Factor. Conclusion: Hageman Factor deficiency causes prolonged activated Partial Thromboplastin Time. However, most of the patients are asymptomatic for many years despite Hageman Factor deficiency.

A Review of an Unorthodox Argatroban Infusion Rate for Anticoagulation in a Patient Case

Argatroban is an intravenous DTI （direct synthetic thrombin inhibitor） that is not routinely used for anticoagulation; thus, expertise surrounding its use is very limited. Therefore, this case reviews an unusually high argatroban infusion rate, which was needed to prevent further emboli formation in a patient. In this case, a 61-year-old Caucasian male patient exhibited heparin resistance during an intraoperative vascular procedure as measured by activated clotting time and PTT （partial thromboplastin time）. The patient had multiple occlusions in his right lower extremities and underwent embolectomies of the right popliteal and posterior tibial arteries. The clinical pharmacist was consulted to manage the argatroban infusion once heparin was discontinued. The therapeutic window required a PTr of 1.5-3 times the patient baseline （35-75 s）. The patient was reported to be 89 kg with a baseline PTT of 24.7 s and INR （international normalized ratio） of 0.98. The starting dose ofargatroban was initiated by the pharmacist at 2 mcg/kg/min （10.7 mL/h） as the patient did not have hepatic failure or sepsis. The patient was maintained on argatroban in the therapeutic PTT window for more than 72 h; however, frequent and aggressive dose increases, to a final rate of 7.5 mcg/kg/min （40 mL/h）, were needed to maintain the therapeutic PTT level. From the case, the cause of heparin resistance still has not been determined despite a hematologic work-up; however, this patient required an unusually high infusion rate of argatroban to maintain a therapeutic PTT during the hospital course before being changed to an anticoagulation regimen for discharge.

Inhibiting effects of low-molecular weight heparin and adrenocortical hormone on hemolysis of red cells in patients with paroxysmal nocturnal hemoglobinuria in vitro

OBJECTIVE: To study the effects of low-molecular weight heparin (LMWH) and adrenocortical hormone (dexamethasone) on the hemolysis of red cells of patients with paroxysmal nocturnal hemoglobinuria (PNH) in vitro. METHODS: Using Ham's test and micro-complement lysis sensitive test (mCLST), the changes in hemolysis of red cells from 6 typical PNH cases were examined after adding LMWH and dexamethasone in different concentrations into the test solution in vitro. The effects of LMWH and dexamethasone on the coagulation of the tested blood samples were also studied using the activated partial thromboplastin time (APTT) test. RESULTS: Both LMWH and dexamethasone inhibited the hemolysis of PNH red cells, and they also showed a synergistic effect. The inhibiting effects were dose-dependent. Moreover, a tolerable dose of LMWH induced a limited prolongation of APTT. Dexamethasone showed two possible mechanisms in the inhibition of PNH red cells hemolysis through Ham's test and mCLST, respectively: (1) inhibiting both antibodies binding to red cells and (2) the initiation of the activation of complement 3 (C3). LMWH could inhibit hemolysis as determined by both Ham's test and mCLST, which indicated that LMWH could block the activation of complement cascade. CONCLUSIONS: Both LMWH and dexamethasone could inhibit hemolysis in PNH, and they showed a synergistic effect. Their mechanisms of inhibiting hemolysis differed from each other. Furthermore, a tolerable dose of LMWH induced a limited prolongation of APTT. LMWH might be useful for controlling acute hemolysis in patients with PNH and reducing the dose of adrenocortical hormone.

Clinical significance of plasma tissue factor pathway and urokinase-type plasminogen activator system in cancer patients

OBJECTIVE: To evaluate variations in the plasma tissue factor (TF) and urokinase type plasminogen activator (u-PA) system and their relationship with clinical cancer type, pathological classification and metastatic status in cancer patients. METHODS: Plasma levels of TF and its inhibitor (TFPI), as well as u-PA and its receptor (u-PAR) were measured using ELISA in 76 patients with malignant tumors and 24 patients with benign tumors. RESULTS: Plasma levels of TF and u-PAR in the malignant tumor group were significantly higher than those of the benign tumor group and the normal control. U-PA and u-PAR increased significantly in patients with esophageal and gastric cancer. However, most of these parameters except TFPI did not vary according to pathological classification. A significant elevation was evident in patients with local infiltration, lymph node involvement and distal metastasis, while u-PAR only increased in the latter two categories. CONCLUSIONS: Both the TF and u-PA systems are activated in cancer patients. U-PA and its receptor might prove to be a clinically useful marker for disease progression.

2种试剂对实验动物凝血酶原时间检测结果的比对分析

目的:比对分析仪器配套的2种试剂对不同实验动物凝血酶原时间测定值,评价检测结果是否存在差异。方法:用Thromborel-S(TS)与Thromboplastin.C.Plus(CPLUS)2种凝血酶原试剂分别对实验动物标本进行检测,然后对检测结果进行配对t检验、相关性分析及信度检验。结果:不同实验动物凝血酶原时间,CPLUS试剂检测结果高于TS试剂,且两组数据存在显著性差异。结论:TS试剂与CPLUS试剂对实验动物凝血酶原时间的检测结果存在显著差异,不存在一致性,在同一个毒性研究中不可以交叉使用这2种试剂。

Extrahepatic synthesis of coagulation factor Ⅶ by colorectal cancer cells promotes tumor invasion and metastasis

Background Blood coagulation factor Ⅶ （FⅦ） is physiologically synthesized in the liver and released into the blood. Binding of FⅦ to tissue factor （TF） is related to the metastatic potential of tumor cells, also a significant risk factor in the development of hepatic metastasis in patients with colorectal cancer （CRC）. It has been found that some cancer cells can produce FⅦ extrahepatically. However, litte is known about FⅦ and CRC. We therefore hypothesized that CRC cells may synthese FⅦ, leading to tumor invasion and metastasis.Methods We detected the expression of FⅦ protein in 55 CRC specimens by immunohistochemical staining. The FⅦ mRNA in 45 of 55 CRC cases, 6 colon cancer cell lines and one hepatoma cell line was measured by real-time reverse transcription-PCR （RT-PCR）. Transwell invasion assays were performed to evaluate the changes of cell migration and invasion of LoVo cancer cells in vitro. We further observed the likely effectors regulated by the TF/FⅦa complex Western blotting assay.Results Extrahepatic synthesis of FⅦ was detected in the cytoplasm of 32 （58.2%） CRC specimens byimmunohistochemistry, but not in normal mucosa. Liver metastasis （P=0.003） and TNM staging （P=0.005） were significantly correlated with FⅦ antigen expression. The positive ratios in stages Ⅰ, Ⅱ, Ⅲ and Ⅳ were 33.3%, 40.0%,52.4% and 87.5%, respectively. The expression of FⅦ mRNA in CRC with hepatic metastasis was significantly higher than CRC without hepatic metastasis （5.33±2.88 vs. 1.47±0.51, P=0.03）. Ectopic FⅦa induced a slight increase （1.34-fold） in the number of migrating cells, which was inhibited by the specific TF antibody. The formation of TF/FⅦacomplex resulted in a marked increase in the expression of matrix metalloproteinases （MMP）-2 （3.5-fold） and MMP-9（4.7-fold） in a time-dependent and dose-dependent manner.Conclusions Extrahepatic synthesis of FⅦ by CRC cells may promote tumor invasion and metastasis. MMPs, as downstream effectors of TF/FⅦa signaling, facilitate the development of metastasis in colon cancer.

Dynamically monitoring tissue factor and tissue factor pathway inhibitor following secondary brain injury

Objective: To study the altering rule of coagulation function at molecular level in patients with secondary brain injury (SBI). Methods: Tissue factor (TF) and tissue factor pathway inhibitor (TFPI) were studied in 32 patients 1, 2, 3 and 7 days after craniocerebral injury. Repeated cranial CT scans and platelet counts were made simultaneously. Same measurements were done in 30 normal adults except CT scan. Results: No obvious difference was found in age, sex and platelet count between the injured and the normal groups. TFPI/TF decreased markedly in the first week after injury in patients with SBI, but only decreased on the 7th day in the patients without obvious SBI. For the patients who developed delayed intracranial hematoma (DIH) or hematoma enlargement, TF rose only 1 and 2 days after injury, but TFPI had a tendency to rise again after a fall on the 3rd day. For those patients who developed no DIH, TF rose all the time within the 1st week. Conclusions: Decrease of TFPI/TF for a long time, especially within 3 days after injury, may be one of the most important reasons for SBI. High expression of TF for a relative short time and increase of TFPI after a fall within 3 days may be one of the important reasons for DIH or hematoma enlargement.

Effect of all-trans retinoic acid and arsenic trioxide on tissue factor expression in acute promyelocytic leukemia cells

OBJECTIVE: To study the effect of all-trans retinoic acid (ATRA) and arsenic troxide (As2O3) on tissue factor (TF) expression and procoagulant activity (PCA) of acute promyelocytic leukemia (APL) cells in vivo and in vitro. METHODS: PCA from freshly isolated APL blasts from APL patients treated with ATRA or As2O3 was detected using a one-stage clotting assay. TF antigen was detected by ELISA and TF mRNA by RT-PCR. The maturation sensitive (NB4) or resistant subclones (NB4-R1) of the promyelocytic NB4 cell line, as well as U937 cells infected with pMSCV-PML-RARa treated with or without ATRA or As2O3, were also examined. RESULTS: Both ATRA and As2O3 can down-regulate the TF antigen, its mRNA transcription and membrane PCA of APL cells in vivo and in vitro, in a time-dependent manner. The TF antigen level in PML-RARa + U937 cells was significantly higher than that in U937 cells infected with retrovirus vector. Both ATRA and As2O3 can also down-regulate the TF antigen in U937 cells transfected with or without PML-RARa. CONCLUSION: Tissue factor expression and PCA in APL cells may be down-regulated by ATRA and As2O3. By down-regulating TF expression, As2O3 might also be used to improve the DIC-related hemorrhage in APL. Our data indicate that elevated TF antigen in PML-RARa + U937 may be related to the fusion protein PML-RARa. The down-regulating effect of ATRA and As2O3 on TF expression in U937 cells might not involve this fusion protein.

Iridoid glycosides extracted from Zhizi(Fructus Gardeniae)decrease collagen-induced platelet aggregation and reduce carotid artery thrombosis in an invivo rat model

OBJECTIVE: To investigate the anti-platelet aggregation and antithrombotic effects in rats of iridoid glycosides extracted from Zhizi (FructusGardeniae). METHODS: The present study evaluated the antithrombotic activity of iridoid glycosides (IGs) in a rat model of carotid artery thrombosis. The effects on coagulation, such as thromboplastin time (APTT), thrombin time (TT) and prothrombin time (PT), and the effect on collagen-induced platelet aggregation in vivo were investigated. Rats were intragastrically administered IGs (50, 100 or 200 mg/ kg) twice daily for 3 days. RESULTS: IGs were shown for the first time to have an antithrombotic action through the inhibition of platelet aggregation, with little effect on the coagulation time of peripheral blood. Our results also showed that IGs may significantly and dose-dependently reduce arterial thrombus load in a model of carotid artery thrombosis and inhibit collagen-induced platelet aggregation in rats. IGs (100or 200 mg/kg) had no significant effect on APTT and PT, but did lengthenTT at a higher dose. CONCLUSION: These data, together with the previously reported neuroprotective effects of IGs in rats with cerebral ischemia, suggest that the antithrombotic action of IGs may potentially contribute to the treatment of cerebral ischemic diseases, including cerebral apoplexy.

Hypercoagulability in cancer patients grouped by syndromes differentiated with the theory of abnormal hilit in traditional Uyghur medicine

OBJECTIVE:To investigate the relationship in malignant-neoplasm patients of hypercoagulability between syndromes differentiated with the theory of abnormal hilit in traditional Uyghur medicine(TUM).METHODS:A total of 248 patients with malignant tumors were enrolled.Based on the theory of TUM they were divided into two groups:abnormal Savda and abnormal Non-Savda(including abnormal Khan,abnormal Sepra and abnormal Belghem types);fifty healthy volunteers were selected as controls.Platelet(PLT),prothrombin time(PT),plasma fibrinogen(FIB),thrombin time(TT),activated partial thromboplastin time(aPTT)and D-Dimer(D-D)were measured in both groups.RESULTS:Compared with the control and abnor-mal Non-Savda groups,in the abnormal Savda group the PLT count increased(P<0.05),the PT was lengthened(P<0.01),and the FIB significantly increased(P<0.01).D-Ds in the three groups were significantly different(P<0.05).No significant difference was found inTT and aPTT values(P>0.05).CONCLUSION:Hypercoagulability existed in patients with malignant tumors in the different types of TUM syndromes,especially in the abnormal Savda group;this was characterized by increased blood viscosity,platelet aggregation and thrombosis.D-D appears to be a significant predictor for the therapeutic effect of TUM in relation to malignant tumor therapies.

In vitro assessment of the effect of Undaria pinnatifida extracts on erythrocytes membrane integrity and blood coagulation parameters of Equus caballus

Objective:To study the activity of polysaccharides extracted from Undaria pinnatifida(U.pinnatifida)in vitro on red blood cell of Equus caballus,and compare it with heparin.Methods:Algal extracts was tested at two different concentrations 10 mg/mL and 20 mg/mL.In all studies,using horse red blood cells,control experiments were carried out without extract.We evaluated the toxicity of algal extracts through trypan blue test and haemolysis test and anticoagulant action measured by activated partial thromboplastin time,prothrombin time and fibrinogen test.Results:The polysaccharide extract of U.pinnatifida appeared to have no cytotoxic effect on the horse red blood cells.The values of prothrombin time,activated partial thromboplastin time and fibrinogen were significantly changed in the presence of the extract.Conclusions:This study suggests a possible exploitation of U.pinnatifida,thriving in the lagoon of Venice,as a source of anticoagulant drug,with the aim of transforming waste into a valuable biomass.