Change of Coagulation Factor Ⅷ and Antithrombin Ⅲ Activity in Bank-Stored Blood

Coagulation factor Ⅷ and antithrombin Ⅲ activity were detected in 15 health donors. It was found that antithrombin Ⅲ activity decreased obviously 12 h after blood drawing. It lost 56 % of the activity at the 3rd day, and 70 % of the activity at the 7th day. FⅧ:c showed no obvious change after 24 h, until the 3rd day. It lost 40 %-60 % of the activity after 36 h and was reduced to the 30 % of the original activity at the 5th day. Our results suggested that at the 3rd day coagulation factor Ⅷ of bank stored blood can be used to replenish antithrombin Ⅲ, while bank stored blood in one day can be used to replenish FⅧ.

ABO Blood Groups and Their Relationship with Coagulation Factor VIII in Healthy Adults

Background: ABO blood group distribution defers with racial and geographic variations. They are related to diseases like cardiovascular diseases, cerebral thromboembolism. ABO blood group system may influence coagulation factor VIII which may increase the future risk of thrombosis. Aim: To assess the relation of ABO blood group with coagulation factor VIII in healthy adults. Material and Methods: A prospective type of analytical cross-sectional study was conducted in the Department of Physiology, Dhaka Medical College, Dhaka from July 2019 to June 2020. After obtaining ethical clearance, a total of 190 healthy adults were selected from different areas of Dhaka city based on inclusion and exclusion criteria, with ages ranging from 18 - 45 years. The subjects were interviewed and detailed history regarding personal, family, medical and drug were taken. Prior to sample collection, informed written consent was taken from the participants. Individuals of blood group A were selected as group A, blood group B as group B, blood group AB as group AB and blood group O as group O. Coagulation factor VIII was measured in the Department of Hematology and BMT Unit, Dhaka Medical College Hospital, Dhaka. Blood grouping was done in the Department of Physiology, Dhaka Medical College, Dhaka. Statistical Analysis: For statistical analysis, ONE way ANOVA followed by Bonferroni test were considered using SPSS 25.0 version. Results: In this study, blood group B was most common (33.2%). Coagulation factor VIII was significantly higher (p < 0.001) in blood group A (105.76% ± 11.82%), B (112.00% ± 15.02%), AB (109.80% ± 11.93%) than blood group O (82.00% ± 12.86%). No significant difference was observed among A, B and AB blood groups regarding coagulation factor VIII. Conclusions: It can be concluded that blood group A, B, AB individuals may have more chance of thrombosis due to significantly higher coagulation factor VIII than blood group O individuals.

Effects of blood purification combined with Xuebijing on coagulation, immunity, inflammation and vascular factors in sepsis patients

Objective:To investigate the effects of blood purification combined with Xuebijing on coagulation, immunity, inflammation and vascular factors in sepsis patients.Methods: 82 sepsis patients admitted to the Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University from January 2017 to January 2019 were selected as the research objects. According to the random drawing method, 41 cases in the control group and 41 cases in the observation group were divided into two groups. The control group was treated with routine western medicine, including antibiotic therapy, blood sugar control, respiratory support and nutritional support. The observation group was treated with continuous blood purification combined with Xuebijing on the basis of the control group. The changes of coagulation index, immune factor, inflammatory reaction and vascular factor levels were observed before and after treatment in two groups.Results:After treatment, the levels of activated partial thromboplastin time (APTT), prothrombin time (PT), D-Dimer (DD), CD8+, procalcitonin (PCT), Tumor Necrosis Factor-α (TNF-α), high mobility group box-B1 (HMGB1) and soluble fms-like tyrosine kinase,(sFLT)in the two groups were significantly lower than those before treatment, while the levels of CD4+, CD4+/CD8+, and vascular endothelial growth factor (VEGF) were significantly higher than those before treatment;and the levels of APTT, PT, DD, CD8+, PCT, TNF-a, HMGB1 and sFLT in the observation group after treatment were significantly lower than those in the control group, the levels of CD4+, CD4+/CD8+, and VEGF in the observation group after treatment were significantly higher than those in the control group, there was a significant difference in each indexes between the different groups after treatment. Conclusions:Continuous blood purification combined with Xuebijing therapy can effectively improve the coagulation function of sepsis patients, enhance the immune mechanism of patients, reduce inflammation and protect vascular endothelial function. It has clinical popularization significance.

Effect of Dan seven soft capsule adjuvant therapy on serum inflammatory factors, coagulation function and blood rheology indexes in patients with acute hemorrhagic cerebrovascular disease

Objective: To investigate the effect of Dan seven soft capsule on the treatment of acute hemorrhagic cerebrovascular disease and the influence of serum inflammatory factors, coagulation function and blood rheology indexes. Methods: A total of 112 cases of patients with acute hemorrhagic cerebrovascular disease, according to the random data table were divided into the control group (n=57) and observation group (n=55), the patients in the control group received routine treatment combined with edaravone, on the basis of the treatment of the control group, the observation group was treated with Dan seven soft capsule. The serum levels of inflammatory factors, coagulation function and blood rheology indexes were compared between the two groups before and after treatment. Results: Before treatment, there were no significant difference in the inflammatory factors (hs-CRP, TNF-α and IL-6), blood coagulation function (FIB, PT and APTT) and hemorheology (high cut whole blood viscosity, low cut whole blood viscosity and plasma viscosity) levels between the control group and observation group. Compared with the levels of the same group before treatment, two groups of hs-CRP, TNF-α, IL-6, FIB, high cut whole blood viscosity, low cut whole blood viscosity and plasma viscosity level after treatment were significantly decreased, and levels in the observation group were significantly lower than those in the control group;Compared with the group before treatment, the levels of PT and APTT in the two groups were significantly increased, and the observation group was significantly higher than the control group. Conclusion: Dan seven soft capsule in the treatment of acute hemorrhagic cerebrovascular disease can effectively reduce the level of serum inflammatory factors, improve coagulation function and blood rheology index, it has an important clinical value.

Preparation and Structure of a New Coagulation Factor XI Catalytic Domain for Drug Discovery

Human blood coagulation factor XI （FXI） is a key enzyme in the amplification phase of blood coagulation cascade, and is recognized as an important target for anti-coagulant development in recent years. We designed a new mutant form of FXIa catalytic domain rhFXI370-607 （N73Q-N113Q-C123S）, and report here the facile preparation, protein crystallization, and crystal structure of this protein. We highlight a few unique structural features of FXIa after comparison with the trypsin family serine proteases at sequence and structural levels. This work provides a foundation to develop new small molecular FXIa inhibitors with increased potency and specificity.

In silico evidence of Remdesivir action in blood coagulation cascade modulation in COVID-19 treatment

BACKGROUND Coronavirus disease 2019(COVID-19)has demonstrated several clinical manifestations which include not only respiratory system issues but also liver,kidney,and other organ injuries.One of these abnormalities is coagulopathies,including thrombosis and disseminated intravascular coagulation.Because of this,the administration of low molecular weight heparin is required for patients that need to be hospitalized.In addition,Remdesivir is an antiviral that was used against Middle East Acute Respiratory Syndrome,Ebola,Acute Respiratory Syndrome,and other diseases,showing satisfactory results on recovery.Besides,there is evidence suggesting that this medication can provide a better prognosis for patients with COVID-19.AIM To investigate in silico the interaction between Remdesivir and clotting factors,pursuing a possibility of using it as medicine.METHODS In this in silico study,the 3D structures of angiotensin-converting enzyme 2(ACE2),Factor I(fibrinogen),Factor II(prothrombin),Factor III(thromboplastin),Factor V(proaccelerin),Factor VII(proconvertin),Factor VIII(antihemophilic factor A),Factor IX(antihemophilic factor B),Factor X(Stuart-Prower factor),and Factor XI(precursor of thromboplastin(these structures are technically called receptors)were selected from the Protein Data Bank.The structures of the antivirals Remdesivir and Osetalmivir(these structures are called ligands)were selected from the PubChem database,while the structure of Atazanavir was selected from the ZINC database.The software AutoDock Tools(ADT)was used to prepare the receptors for molecular docking.Ions,peptides,water molecules,and other ones were removed from each ligand,and then,hydrogen atoms were added to the structures.The grid box was delimited and calculated using the same software ADT.A physiological environment with pH 7.4 is needed to make the ligands interact with the receptors,and still the software Marvin sketch®(ChemAxon®)was used to forecast the protonation state.To perform molecular docking,ADT and Vina software was connected.Using PyMol®software and Discovery studio®software from BIOVIA,it was possible to analyze the amino acid residues from receptors that were involved in the interactions with the ligands.Ligand tortions,atoms that participated in the interactions,and the type,strength,and duration of the interactions were also analyzed using those software.RESULTS Molecular docking analysis showed that Remdesivir and ACE2 had an affinity energy of-8.8 kcal/moL,forming a complex with eight hydrogen bonds involving seven atoms of Remdesivir and five amino acid residues of ACE2.Remdesivir and prothrombin had an interaction with six hydrogen bonds involving atoms of the drug and five amino acid residues of the clotting factor.Similar to that,Remdesivir and thromboplastin presented interactions via seven hydrogen bonds involving five atoms of the drug and four residues of the clotting factor.While Remdesivir and Factor V established a complex with seven hydrogen bonds between six antiviral atoms and six amino acid residues from the factor,and Factor VII connected with the drug by four hydrogen bonds,which involved three atoms of the drug and three residues of amino acids of the factor.The complex between Remdesivir and Factor IX formed an interaction via 11 hydrophilic bonds with seven atoms of the drug and seven residues of the clotting factor,plus one electrostatic bond and three hydrophobic interactions.Factor X and Remdesivir had an affinity energy of-9.6 kcal/moL,and the complex presented 10 hydrogen bonds and 14 different hydrophobic interactions which involved nine atoms of the drug and 16 amino acid residues of the clotting factor.The interaction between Remdesivir and Factor XI formed five hydrogen bonds involving five amino acid residues of the clotting factor and five of the antiviral atoms.CONCLUSION Because of the in silico significant affinity,Remdesivir possibly could act in the severe acute respiratory syndrome coronavirus 2 infection blockade by interacting with ACE2 and concomitantly act in the modulation of the coagulation cascade preventing the hypercoagulable state.

Effects of low molecular weight heparin on the function of blood coagulation and serum levels of TNF-α, CK-MB, CRP of patients with acute exacerbations of chronic obstructive pulmonary diseases and respiratory failur

Objective:To study the effects of low molecular weight heparin on the function of blood coagulation and serum levels of tumor necrosis factor-α(TNF-α), creatine kinase isoenzyme (CK-MB), C-reactive protein (CRP) of patients with acute exacerbations of chronic obstructive pulmonary diseases and respiratory failure.Methods:A total of 80 patients with acute exacerbations of chronic obstructive pulmonary diseases and respiratory failure in our hospital from June 2014 to October 2016 were enrolled in this study. The subjects were divided into the control group (n=40) and the treatment group (n=40) randomly. The control group were treated with conventional treatment, the treatment group were treated with the conventional treatment combined with low molecular weight heparin. The two groups were treated for 7 d. The D-dimer (D-D), fibrinogen (FBG), pro thrombin time (PT), thrombin time (TT), TNF-α, CK-MB and CRP of the two groups before and after treatment were compared.Results:There were no significantly differences of the blood levels of D-D, FBG, PT and TT of the two groups before treatment. After treatment, the blood levels of D-D and FBG of the two groups were significantly lower than before treatment, and that of the treatment group were significantly lower than the control group, the PT and TT of the two groups were significantly higher than before treatment, and that of the treatment group were significantly higher than the control group. There were no significantly differences of the serum levels of the TNF-α, CK-MB and CRP of the two groups before treatment. After treatment, the serum levels of the TNF-α, CK-MB and CRP of the two groups were significantly lower than before treatment, and that of the treatment group were significantly lower than the control group.Conclusion:Low molecular weight heparin can significantly reduce the inflammatory factors of the patients with acute exacerbations of chronic obstructive pulmonary diseases and respiratory failure, can alleviath the patients conditions and reduce the myocardial damage.

Risk Factors for Mortality in Critically Ill Patients with Coagulation Abnormalities:A Retrospective Cohort Study

Objective Coagulation abnormalities are common and prognostically significant in intensive care units(ICUs)and are associated with increased mortality.This study aimed to explore the association between the levels of coagulation markers and the risk of mortality among ICU patients with coagulation abnormalities.Methods This retrospective study investigated patients with coagulation abnormalities in the ICU between January 2021 and December 2022.The initial point for detecting hemostatic biomarkers due to clinical assessment of coagulation abnormalities was designated day 0.Patients were followed up for 28 days,and multivariate logistic regression analysis was utilized to identify risk factors for mortality.Results Of the 451 patients analyzed,115 died,and 336 were alive at the end of the 28-day period.Multivariate analysis revealed that elevated thrombin-antithrombin complex(TAT),tissue plasminogen activator inhibitor complex(tPAIC),prolonged prothrombin time,and thrombocytopenia were independent risk factors for mortality.For nonovert disseminated intravascular coagulation(DIC)patients,older age and thrombocytopenia were associated with increased risks of mortality,whereas elevated levels of plasminα2-plasmin inhibitor complex(PIC)were found to be independent predictors of survival.In patients with overt DIC,elevated levels of tPAIC were independently associated with increased risks of mortality.Nevertheless,thrombocytopenia was independently associated with increased risks of mortality in patients with pre-DIC.Conclusion Coagulation markers such as the TAT,tPAIC,PIC,and platelet count were significantly associated with mortality,underscoring the importance of maintaining a balance between coagulation and fibrinolysis.These findings highlight the potential for targeted therapeutic interventions based on specific coagulation markers to improve patient outcomes.

温肺通络经验方联合沙丁胺醇对慢性肺栓塞痰瘀互结证患者凝血因子X、VⅡ活性的影响

目的:观察温肺通络经验方联合沙丁胺醇治疗慢性肺栓塞痰瘀互结证对患者凝血因子X、VⅡ活性的影响。方法:选取我院于2017年4月~2020年5月收治的慢性肺栓塞(中医辨证分型属痰瘀互结证)患者106例,参照其治疗方案进行均分组,对照组53例在抗凝、抗感染、化痰的基础上给予沙丁胺醇雾化吸入治疗,观察组53例在对照组基础上给予温肺通络经验方治疗。记录两组中医证候积分、炎症因子、凝血相关因子、肺动脉压、第一秒用力呼气容积占预计值(FVE1占预计值)的变化。结果:治疗后两组咳嗽、胸闷、呼吸困难、唇甲青紫、食欲不振及中医证候总积分等均大幅下降(P<0.05),且观察组治疗后各项中医证候总积分较对照组更低(P<0.05)。治疗后两组纤维蛋白原(FIB)、血小板计数(PLT)等均大幅提升,肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、凝血因子X、VⅡ的活性及D-二聚体(D-D)等均大幅下降(P<0.05),且观察组治疗后FIB、PLT较对照组更高,TNF-α、IL-1β、凝血因子X、VⅡ的活性及D-D较对照组更低(P<0.05)。治疗后两组FVE1占预计值大幅提升(P<0.05),肺动脉压大幅下降(P<0.05),且观察组治疗后FVE1占预计值较对照组更高,肺动脉压较对照组更低(P<0.05)。结论:温肺通络经验方联合沙丁胺醇治疗慢性肺栓塞痰瘀互结证可改善凝血相关因子的表达,减轻炎症反应和临床症状,提高肺功能。

不同浓度钙离子对凝血Ⅰ、Ⅱ及Ⅲ因子的作用

家兔血液与不同浓度ＣａＣｌ２溶液混合后，随着Ｃａ２＋浓度的增加血凝时间延长，当血中Ｃａ２＋浓度达０．０５４ｍｏｌ／Ｌ时，出现抗凝；０．７２ｍｏｌ／ＬＣａＣｌ２溶液抗凝兔血置３７℃水浴３０，１２０ｍｉｎ后，再以生理盐水稀释，血液仍能恢复凝固。表明ＣａＣｌ２抗凝血中的纤溶系统未被激活，其抗凝作用具有可逆性；其中的凝血Ⅲ因子无变性、降解、失活现象，对纤维蛋白原含量无影响。

凝血因子Ⅱ、Ⅴ基因多态性与脑梗死的关联研究

目的探讨中国湖南长沙地区汉族人群中凝血因子Ⅱ(FⅡ)、凝血因子Ⅴ(FⅤ)基因单核苷酸多态性与脑梗死之间的关联。方法采用PCR及飞行时间质谱技术对351例确诊为脑梗死的汉族患者(病例组)及417例对照组FⅡ基因rs1799963位点、FⅤ基因rs6025位点进行基因分型。结果病例组FⅡ基因rs1799963位点基因型均为G/G,对照组中基因型为G/G和A/G。病例组与对照组中FⅤ基因rs6025位点基因型均为G/G。对基因型及等位基因频率进行χ2检验示,病例组FⅡ基因rs1799963位点的基因型分布与对照组相比较差异无统计学意义(P>0.05);病例组等位基因频率与对照组相比较差异无统计学意义(P>0.05)。Logistic回归分析示,FⅡ基因rs1799963位点多态性与脑梗死不相关(P>0.05)。结论 FⅡ基因rs1799963位点多态性和FⅤ基因rs6025位点多态性均可能与中国长沙汉族人群脑梗死之间不存在关联。

首批人凝血因子Ⅱ和Ⅹ浓制剂国家标准品协作标定

目的协作标定首批人凝血因子Ⅱ和Ⅹ浓制剂国家标准品。方法用世界卫生组织 98 590批人凝血因子Ⅱ和Ⅹ浓制剂国际标准品 ,采用一期法标定我国首批人凝血因子Ⅱ和Ⅹ浓制剂国家标准品 ,将标准品分别于4℃、2 2℃、37℃保存 5个月 ,进行稳定性考查。结果人凝血因子Ⅱ和Ⅹ国家标准品的效价分别为 1 6 .1IU 支和 1 2 .1IU 支 ,稳定性良好。

炎症因子和肌源性分化对犬脐血间质干细胞MHC-Ⅱ表达的影响

目的研究炎症因子IL-1β、TNF-α和INF-γ以及肌源性分化,对犬脐血间质干细胞MHC-Ⅱ表达的影响。方法取犬脐带血,密度梯度离心法分离出单个核细胞,经贴壁培养扩增间质干细胞。取第4代细胞,在含IL-1β、TNF-α、INF-γ的培养液培养72 h,以及用5-氮杂胞苷诱导分化72 h后,免疫组化法检测MHC-Ⅱ的表达。结果未分化的犬脐血间质干细胞为MHC-Ⅰ(+)、MHC-Ⅱ(-)细胞,肌源性分化以及炎症因子IL-1β、TNF-α、INF-γ不能诱导其表达MHC-Ⅱ。结论肌源性分化和炎症因子IL-1β、TNF-α和INF-γ不能诱导犬脐血间质干细胞表达MHC-Ⅱ,提示其具有极低的免疫原性,可能适合进行同种异体细胞移植。

AngⅡ对血管平滑肌细胞PDGF受体表达的影响

目的:研究血管紧张素Ⅱ(AngⅡ)对血管平滑肌细胞血小板源生长因子(PDGF)受体表达的影响。方法:采用大鼠主动脉球囊内皮剥脱术制备主动脉再狭窄模型,观察形态学变化;放免法测定主动脉AngⅡ含量;免疫印迹法测定主动脉PDGFβ受体含量,并与假手术组相比较。培养大鼠主动脉血管平滑肌细胞(VSMC),AngⅡ刺激正常培养的与洛沙坦预处理过的VSMC6h,测定PDGFβ受体含量。结果:球囊内皮剥脱术后14d,主动脉中层VSMC大量增殖,内膜显著增厚,AngⅡ含量显著升高(P<0.05),PDGFβ受体表达显著增强(P<0.05)。AngⅡ诱导VSMCPDGFβ受体表达显著增强(P<0.01),AngⅡ受体拮抗剂洛沙坦完全抑制AngⅡ对PDGFβ受体上调的诱导作用。结论:AngⅡ可通过其Ⅰ型受体诱导血管平滑肌细胞PDGF受体上调,这可能是AngⅡ促VSMC发生增殖的一个重要机制。

安步乐克对短暂性脑缺血发作患者凝血指标及血管紧张素Ⅱ的影响

目的探讨安步乐克对短暂性脑缺血发作(TIA)患者凝血指标及血管紧张素Ⅱ(AngⅡ)水平的影响。方法将60例TIA患者随机分为治疗组和对照组各30例。治疗组予以安步乐克口服治疗,对照组予以肠溶阿司匹林口服治疗,2组均连续服用10d。检测并比较2组治疗前后凝血指标[纤维蛋白原(FIB)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、内源性凝血因子FⅧ:C水平、血管性假性血友病因子(vWF)]及AngⅡ水平。结果治疗组FIB、FⅧ:C、vWF、AngⅡ水平低于对照组,PT、APTT水平高于对照组,差异均有统计学意义(P<0.05和P<0.01)。对照组治疗后AngⅡ水平与治疗前比较差异无统计学意义(P>0.05)。结论安步乐克可以显著改善TIA患者的凝血指标和AngⅡ水平。

原因不明不孕患者子宫内膜胰岛素样生长因子-Ⅱ和Ⅰ型受体的表达与性激素的调控

目的 :探讨原因不明不孕患者子宫内膜胰岛素样生长因子 - (IGF- )及其 型受体 (IGF- R)的表达 ,血清性激素的变化与子宫内膜接受性的关系。方法 :采用逆转录聚合酶链反应 (RT- PCR)技术 ,对 34例原因不明不孕患者 (研究组 )和 2 1例正常生育妇女志愿者或男性因素不孕妇女 (对组照 )的黄体中期子宫内膜 ,行 IGF- 及 IGF- R m RNA检测 ,放射免疫法测定同期血清雌二醇 (E2 )、孕酮 (P)水平。结果 :研究组黄体中期子宫内膜IGF- m RNA、IGF- R m RNA表达水平分别为 0 .6 6 2± 0 .371、0 .5 82± 0 .2 5 7,低于对照组 0 .96 1± 0 .389、0 .82 9± 0 .341(均 P<0 .0 5 )。研究组血清 P水平为 (2 3.782± 15 .4 5 9) nmol/ L ,显著低于对照组 (43.14 2± 16 .5 49) nmol/ L(P<0 .0 0 5 ) ,而两组 E2 无显著性差异。相关分析示两组 IGF- m RNA与 IGF- R m RNA均呈正相关 ,r分别为0 .92 3、0 .738(P<0 .0 5 )。两组 P与 IGF- m RNA均呈正相关 ,r分别为 0 .716、0 .5 88(P<0 .0 5 )。两组 P与 IGF- R m RNA均呈正相关 ,r分别为 0 .5 19、0 .5 0 5 (P<0 .0 5 )。结论 :原因不明不孕患者黄体中期孕激素不足可引起子宫内膜 IGF- 及 IGF- R基因表达减弱 ,影响子宫内膜蜕膜化而导致子宫内膜接受性低下 ,

注射用重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白联合清热凉血方治疗中重度难治性银屑病的临床疗效观察

目的 探讨注射用重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白（益赛普）联合中药清热凉血方治疗中重度难治性银屑病的疗效和安全性.方法 选取中日友好医院皮肤科30例中重度银屑病患者,完全随机分为益赛普联合清热凉血方组、阿维A联合清热凉血方组和清热凉血方组,每组10例.益赛普联合中药组在口服中药清热凉血方的基础上予以益赛普50 mg皮下注射,每周1次;阿维A联合清热凉血方组为口服中药基础上每日口服阿维A胶囊30 mg,1次/d;清热凉血方组给予中药清热凉血方治疗,每日2次;疗程均为12周.观察3组患者治疗4、8、12周后银屑病皮损面积和严重程度指数（PASI）、患者整体评价（PGA）、视觉模拟评分（VAS）、生活质量评分及不良反应.结果 治疗12周后,益赛普联合清热凉血方组、阿维A联合清热凉血方组和清热凉血方组的PASI、PGA、VAS评分较治疗前明显降低[PASI评分：（4.6±1.0）分比（28.7±2.3）分,（15.0±0.9）分比（31.9±2.1）分,（19.0±1.7）分比（26.8±1.7）分;PGA评分：（1.40±0.22）分比（5.20±0.20）分,（3.10±0.18）分比（5.60±0.22）分,（4.00±0.21）分比（5.20±0.20）分;VAS评分：（2.20±0.44）分比（7.40±0.43）分,（4.40±0.16）分比（7.90±0.41）分,（5.50±0.27）分比（6.90±0.38）分]（P＜0.05）.治疗8周后,益赛普联合清热凉血方组和阿维A联合清热凉血方组PASI[（9.8±1.3）、（19.2±0.9）分]、PGA[（2.60 ±0.31）、（4.00±0.15）分]、VAS[（4.20±0.33）、（5.20±0.25）分]评分均低于治疗前（P＜0.05）;治疗4周后,益赛普联合清热凉血方组的PASI[（16.6±1.7）分]、PGA[（3.80 ±0.33）分]、VAS[（5.40 ±0.16）分]评分均低于治疗前,阿维A联合清热凉血方组PASI[（27.5±1.7）分]评分低于治疗前,差异均有统计学意义（均P＜0.05）.益赛普联合清热凉血方组治疗4、8、12周后的PASI、PGA、VAS评分和阿维A联合清热凉血方组治疗后8、12周的PASI、PGA、VAS评分均低于清热凉血方组同期指标（均P＜0.05）.益赛普联合清热凉血方组治疗4、8、12周后PASI评分与阿维A联合清热凉血方组比较,差异均有统计学意义（均P＜0.05）.益赛普联合清热凉血方组、阿维A联合清热凉血方组和热凉血方组治疗12周后生活质量评分与治疗前比较,差异有统计学意义[（3.2±0.9）分比（25.1±3.1）分,（16.1±1.6）分比（30.4±2.0）分,（18.9±2.0）分比（25.8±1.7）分]（P＜0.05）.益赛普联合清热凉血方组和阿维A联合清热凉血方组的生活质量评分均低于清热凉血方组,差异有统计学意义（P＜0.05）;益赛普联合清热凉血方组的生活质量评分明显低于阿维A联合清热凉血方组,差异有统计学意义（P＜0.05）.结论 重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白治疗中重度的银屑病,起效迅速、疗效好,是顽固难治性银屑病的治疗方法的选择,其长期疗效以及安全性有待进一步观察.

凝血因子Ⅱ mRNA在人肝细胞癌中表达与临床指标的关系

目的探讨凝血因子Ⅱ mRNA在人肝细胞癌(HCC)组织中的表达及其与HCC临床指标的关系。方法用荧光定量PCR技术检测55例HCC患者凝血因子Ⅱ mRNA的表达,分析目的基因表达量与临床病理指标之间的关系。结果 55例HCC中凝血因子Ⅱ mRNA的相对表达量为(1.184±0.535),凝血因子Ⅱ mRNA在癌组织与癌旁组织表达差异无统计学意义(P>0.05),而高于正常组织中的表达量(P<0.05)。凝血因子Ⅱ mRNA相对表达量与AFP、术后复发显著相关(P<0.05),与肿瘤大小、肝硬化等无相关性(P>0.05)。凝血因子Ⅱ mRNA高表达的患者术后中位生存时间明显短于低表达患者。结论凝血因子ⅡmRNA有可能成为HCC患者术后复发的预测指标。

急性白血病患者血浆因子Ⅱ、Ⅴ凝血活性的研究

对４４例急性白血病患者进行了血浆Ⅱ：Ｃ和Ⅴ：Ｃ的研究。正常对照组Ⅱ：Ｃ活性为９９．８３±２９．１９（％），Ⅴ：Ｃ为１０１．５０±３９．７４（％）。疾病活动期、有出血倾向时Ⅱ：Ｃ降低；当外周血幼稚细胞＞６０％时，Ⅱ：Ｃ降低更明显为５９．１９±２４．５５（％）；以上变化有统计学意义（Ｐ＜０．０５）。缓解期，Ⅱ：Ｃ水平有所恢复，但未达正常。Ⅴ：Ｃ仪表现在疾病活动期活性高于正常，为１５２．８４±７７．４８（％）（Ｐ＜０．０１），在其它组变化不明显。研究结果显示Ⅱ：Ｃ与急性白血病出血倾向相关；Ⅴ：Ｃ则可能与白血病细胞促凝活性相关。

血液灌流联合CVVH对HLSAP患者TG和炎症因子及APACHEⅡ评分的影响

目的:研究血液灌流(HP)联合连续性静脉—静脉血液滤过(CVVH)对高脂血症性重症胰腺炎(HLSAP)患者甘油三酯(TG)、炎症因子及急性生理与慢性健康状况Ⅱ(APACHEⅡ)评分的影响。方法:86例HLSAP患者均分为对照组和观察组,对照组在常规内科治疗基础上进行CVVH治疗,观察组在对照组的基础上再加用HP,记录治疗后两组患者腹痛、腹胀、恶心呕吐、腹膜刺激征症状缓解时间及肠鸣音恢复时间;于治疗前及治疗第1、3及7天时,监测两组患者呼吸频率(RR)、心率(HR)、平均动脉压(MAP)水平、APACHEⅡ评分、腹围及腹压,同时检测血清TG、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及C反应蛋白(CRP)水平。结果:治疗后,观察组患者腹痛、腹胀、恶心呕吐、腹膜刺激征症状缓解时间及肠鸣音恢复时间均显著短于对照组(P<0.05);治疗后,两组患者RR、HR、APACHEⅡ评分、腹围、腹压及血清TG、IL-6、TNF-α、CRP水平显著低于治疗前,同组内比较第1天<第3天<第7天(P<0.05),MAP显著高于治疗前、对照组,同组内比较第1天>第3天>第7天(P<0.05);治疗后同时点观察组RR、HR、APACHEⅡ评分、腹围、腹压及血清TG、IL-6、TNF-α、CRP水平显著低于对照组(P<0.05)。结论:HP联合CVVH治疗HLSAP能降低TG和炎症因子水平及APACHEⅡ评分,从而改善患者症状和预后,提升治疗效果。