长期接受抗凝抗聚药物治疗病人并发脑出血的治疗分析

目的探讨长期接受抗凝抗聚药物治疗病人发生脑出血的治疗方法及疗效。方法回顾性分析2014年8月至2018年8月收治的33例长期接受抗凝抗聚药物治疗的脑出血的临床资料。保守治疗10例,急诊开颅血肿清除+去骨瓣减压术7例,钻孔引流术16例。结果术后死亡1例(3%)。32例平均随访6个月,依据日常生活能力量表:Ⅰ级2例,Ⅱ级11例,Ⅲ级12例,Ⅳ级5例,Ⅴ级2例。结论对长期接受抗凝抗聚药物治疗的脑出血,应密切监测凝血功能及相关指标参数,根据病人的具体情况选择针对性的治疗措施。

长期接受抗凝抗聚药物治疗患者并发脑出血的治疗方法和效果研究

对长期接受抗凝抗聚药物治疗患者并发脑出血的治疗方法和效果展开分析。方法:选取2017年02月至2019年08月,我院收治地长期服用抗凝抗聚药物的脑出血患者24例为研究对象,根据治疗方法分为保守治疗9例,急诊开颅血肿清除术7例,钻孔引流术8例。结果:本组24例患者中,钻孔引流术和开颅血肿清除术的血肿清除率明显高于保守治疗(P<0.05);钻孔引流术总并发症发生率显著低于开颅血肿清除术和保守治疗(P<0.05);钻孔引流术和开颅血肿清除术总治疗效果显著高于保守治疗(P<0.05)。结论:长期接受抗凝抗聚药物治疗并发脑出血患者,采用微创手术治疗,可改善血肿清除率,减少术中出血量,减少治疗时间及降低并发症发生率,可以促进手术安全性的提高。

急性缺血性脑卒中的抗小板聚集药和他汀类药物联合治疗效果分析

目的:探讨他汀类药物联合抗小板聚集药物治疗急性缺血性脑卒中疾病的效果,分析联合用药的临床价值。方法:选取我院收治的急性缺血性脑卒中患者78例作为研究对象,随机平均分为对照组和观察组,给予两组患者基础常规抗小板聚集药物治疗,观察组联合他汀类药物进行治疗;比较两组患者的治疗后不良反应的发生情况,比较两组患者的血脂水平和血液流变学情况。结果:观察组和对照组不良反应发生率较低,进行比较无统计学意义;而血脂水平和血液流变学情况明显改善,但是观察组患者的改善幅度明显更大;进行比较有统计学意义。结论:他汀类药物联合抗小板聚集药物效果显著,能够明显降低患者的血脂水平,降低血液粘稠度和血栓长度,能够显著减少血栓的含量,有利于患者病情的恢复和正常的血液供应;联合用药临床价值高。

Study on Antithrombotic and Antiplatelet Activities of Low Molecular Weight Fucoidan from Laminaria japonica

The antithrombotic and antiplatelet effects of two fucoidan fractions with low molecular weight and different sulfate content from Laminaria japonica were compared in order to examine the influence of chemical character on their antithrombotic activity and the possible mechanism. Both LMW fucoidan fractions exhibited favorable antithrombotic activity in an Fecl3-induced arterial thrombosis. The antithrombotic activity of LMW fucoidan was related with decrease of TXB2 and whole blood viscosity and hematocrit. LMW fucoidan showed a correlation between anticoagulant, antiaggregant and antithrombotic effects in vivo. For LMW fucoidan, antithrombotic activity required high dose of 5-10 nmol kg-1, concomitantly with increase in anticoagulant activity and inhibition of platelet aggregation. Administration of LMW fucoidan significantly promoted the 6-keto-PGF1α content and decreased the TXB2 content, indicating its inhibition of tissue factor pathway and regulation of metabolism of arachidonic acid. By comparison, highly sulfated fucoidan LF2 with Mw 3900 seemed to be a more suitable choice for antithrombotic drug for its antithrombotic activity accompanied with specific inhibitory activity on platelet aggregation, low anticoagulant activity and low hemorrhagic risk in vivo.

Optimization of four types of antimicrobial agents to increase the inhibitory ability of marine Arthrobacter oxydans KQ 11 dextranase mouthwash

We adopted the response surface methodology using single factor and orthogonal experiments to optimize four types of antimicrobial agents that could inhibit biofilm formation by Streptococcus mutans, which is commonly found in the human oral cavity and causes tooth decay. The objective was to improve the function of marine Arthrobacter oxydans KQll dextranase mouthwash （designed and developed by our laboratory）. The experiment was conducted in a three-level, four-variable central composite design to determine the best combination of ZnSO4, lysozyme, citric acid and chitosan. The optimized antibacterial agents were 2.16 g/L ZnSO4, 14 g/L lysozyme, 4.5 g/L citric acid and 5 g/L chitosan. The biofilm formation inhibition reached 84.49%. In addition, microscopic observation of the biofilm was performed using scanning electron microscopy and confocal laser scanning microscopy. The optimized formula was tested in marine dextranase Arthrobacter oxydans KQ11 mouthwash and enhanced the inhibition of S. mutans. This work may be promoted for the design and development of future marine dextranase oral care products.

Comparative study between rivaroxaban and conventional low molecular weight heparin anticoagulant in preventing thrombosis

After entering 2010, as main varieties patents of the global non-peptide angiotensin II receptor antagonists （ARB） expire, strong growth of anti-hypertensive drug market will tend to slow down. In drugs acting on the cardiovascular and blood system, antithrombotie drugs will become a new attraction on the market. Antithrombotic drugs are primarily formed by the anti-platelet aggregation, coagulation system activation of plasminogen thrombolytic drugs and the like. Antiplatelet drugs have both prevention and treatment effect, are the main category of antithrombotic drugs. According to IMS Health data, in 2008, sale of anti-thrombosis drug in global market is 180 million U.S. dollars, an increase of 16 %, while in 2009 the growth rate is only 7.95%, reaching $ 19.5 billion, growth rate of antithrombotic drugs is 7.13% in the world＇ s major pharmaceutical market.

Synthesis of cleavable multi-functional mikto-arm star polymer by RAFT polymerization: example of an anti-cancer drug 7-ethyl-10-hydroxycamptothecin(SN-38) as functional moiety

Multi-functional mikto-arm star polymers containing three different arms [hydrophilic, SN-38-P（OEGMAs_9）11, cationizable, SN-38-P（DMAEMA）3s and hydrophobic, SN-38-P（BMA）26] were prepared by RAFT polymerization via an arm-first approach using a cleavable cross-linker. The star polymers were cleaved to the linear arms with tributylphosphine as a reducing agent. The decrease in molecular weight observed is consistent with the initial stars having approximately five arms, Blue fluorescence was observed when a solution of mikto-arm star was irradiated under a 365 nm light proving the retention of the SN-38 moiety during star formation by RAFT polymerization. Thus these polymer-drug conjugates can be considered as potential delivery vehicles for cancer therapy. The P（DMAEMA） arms can be quaternized using iodomethane, allowing star polymers to bind negatively charged small interfering RNA （siRNA） and potentially be used as a carrier for that material.

M13 Bacteriophage-Polymer Nanoassemblies as Drug Delivery Vehicles

Poly（caprolactone-b-2-vinylpyridine） （PCL-P2VP） coated with folate-conjugated M13 （FA-M13） provides a nanosized delivery system which is capable of encapsulating hydrophobic antitumor drugs such as doxorubicin （DOX）. The DOXqoaded FA-M13-PCL-P2VP assemblies had an average diameter of approximately 200 nm and their structure was characterized using transmission electron microscopy, scanning electron microscopy, and dynamic light scattering. The particles were stable at physiological pH but could be degraded at a lower pH. The release of DOX from the nanoassemblies under acidic conditions was shown to be significantly faster than that observed at physiological pH. In addition, the DOX-loaded FA-M13-PCL-P2VP particles showed a distinctly greater cellular uptake and cytotoxicity against folate-receptor-positive cancer cells than folate-receptor-negative cells, indicating that the receptor facilitates folate uptake via receptor-mediated endocytosis. Furthermore, the DOX-loaded particles also had a significantly higher tumor uptake and selectivity compared to free DOX. This study therefore offers a new way to fabricate nanosized drug delivery vehicles.

Recent therapeutic applications of the theranostic principle with dendrimers in oncology

At the intersection between treatment and diagnosis, nanoparticles technologies are strongly impacting the development of both therapeutic and diagnostic agents.Consequently, the development of novel modalities for concomitant noninvasive therapy and diagnostics known as theranostics as a single platform has gained significant interests. These multifunctional theranostic platforms include carbon-based nanomaterials（e.g., carbon nanotubes）, drug conjugates, aliphatic polymers, micelles, vesicles, core-shell nanoparticles, microbubbles and dendrimers bearing different contrast agents and drugs, such as cytotoxic compounds in the oncology domain. Dendrimers emerged as a new class of highly tunable hyperbranched polymers, and have been developed as useful theranostic platforms. Magnetic resonance imaging, gamma scintigraphy, computed tomography and optical imaging are the main techniques developed with dendrimers in the theranostic domain in oncology. Different imaging agents have been used such as Gd（Ⅲ）,19F, Fe2O3（MRI）,76Br（PET）,111In,88Y,153Gd,188Re,131I（SPECT）,177Lu,gold（CT） and boronated groups, siliconnaphthalocyanines,dialkylcarbocyanines and QDs（optical imaging dyes）.