AIM:To present a series of cases with symptomatic acute extensive portal vein(PV)and superior mesenteric vein(SMV)thrombosis after splenectomy treated by transjugular intrahepatic approach catheter-directed thrombolys...AIM:To present a series of cases with symptomatic acute extensive portal vein(PV)and superior mesenteric vein(SMV)thrombosis after splenectomy treated by transjugular intrahepatic approach catheter-directed thrombolysis. METHODS:A total of 6 patients with acute extensive PV-SMV thrombosis after splenectomy were treated by transjugular approach catheter-directed thrombolysis. The mean age of the patients was 41.2 years.After access to the portal system via the transjugular approach,pigtail catheter fragmentation of clots, local urokinase injection,and manual aspiration thrombectomy were used for the initial treatment of PV-SMV thrombosis,followed by continuous thrombolytic therapy via an indwelling infusion catheter in the SMV,which was performed for three to six days. Adequate anticoagulation was given during treatment, throughout hospitalization,and after discharge. RESULTS:Technical success was achieved in all 6 patients.Clinical improvement was seen in these patients within 12-24 h of the procedure.No complications were observed.The 6 patients were discharged 6-14 d(8±2.5 d)after admission.The mean duration of follow-up after hospital discharge was 40±16.5 mo.Ultrasound and contrast-enhanced computed tomography confirmed patency of the PV and SMV,and no recurrent episodes of PV-SMV thrombosis developed during the follow-up period. CONCLUSION:Catheter-directed thrombolysis via transjugular intrahepatic access is a safe and effective therapy for the management of patients with symptomatic acute extensive PV-SMV thrombosis.展开更多
[Objective] To isolate and preserve a high-activity Douchi fibrinolytic enzyme producing strain from Douchi products. [Method] The Douchi flbrinolytic enzyme producing strain was screened on the selected medium prepar...[Objective] To isolate and preserve a high-activity Douchi fibrinolytic enzyme producing strain from Douchi products. [Method] The Douchi flbrinolytic enzyme producing strain was screened on the selected medium prepared with self-made pork blood powder, the strain with the highest activity was screened out according to the size of hydrolysis cycle, and then preserved in LB medium. [ Rebait] A Douchi fibrinolytic enzyme producing strain with high thrombolytic activity was successfully screened out from the Douchi produced in Hunan, Guangdong and Jiangxi Prov- inces. [ Ceadusioe] The study lays foundation for the development of new-type thrombolytic drugs.展开更多
The aim of this study is to test the patency rate and safety of the accelerated streptokinase dose regimen for coronary thrombolysis compared with the conventional one. One hundred and four patients enterring three ho...The aim of this study is to test the patency rate and safety of the accelerated streptokinase dose regimen for coronary thrombolysis compared with the conventional one. One hundred and four patients enterring three hospitals up to 12 hours after the onset of definite acute myocardial infarction were randomizely treated with intravenous accelerated streptokinase dose regimen ( 1. 5 million units/30 min) (group A, 47 cases) and conventional dose regimen ( 1. 5 million units/60 min) (group B , 57 casese). The reperfusion rate of infarct-related arteries determined by clinical evidence of reperfusion was 76. 6% (36/47) in group A VS 61. 4% (35/57) in group B. There was significant difference in reperfusion rates among patients within 6 hours after the onset of chest pain : 87. 9% (29/33) in group A VS 67. 4 (29/43) in group B(P<0. 05 ). The incidence of mild bleeding , allergic reaction , hypotension was 12. 8 % ( 6/47 ) , 4. 3 % ( 2/47 ) , 12. 8 ( 6/47 ) respectively in group A vs 21. 1 ( 12/57 ) , 3. 5 (2/57) . 17. 5 % ( 10/57) respectively in group B. Compared to conventional dose regimen, intravenous accelerated streptokinase dose regimen for coronary thrombolysis seems to improve reperfusion rate markedly without increasing adverse events such as bleeding , allergic reaction and hypotension. It suggests that accelerated streptokinase therapy deserves more extensive investigation.展开更多
Pulmonary thromboembolism （PTE） is a life-threatening condition with a high early mortality rate caused by acute right ventricular failure and cardiogenic shock. We report a series of three patients who presented wi...Pulmonary thromboembolism （PTE） is a life-threatening condition with a high early mortality rate caused by acute right ventricular failure and cardiogenic shock. We report a series of three patients who presented with acute and subacute submassive PTE. They were suc-cessfully treated by simple catheter-based mechanical thrombectomy and intrapulmonary arterial thrombolysis. Mechanical fragmentation and aspiration of thrombus was performed by commonly used J-wire, multi-purpose and Judkin Right guiding catheters and this obviated the need of specific thrombectomy devices.展开更多
To examine the procoagulant effects of thrombolytic agent on h emostasis and study the role of hemostatic markers as predictors of clinical outcomes. Methods. In the present study, eighteen patients with acute m...To examine the procoagulant effects of thrombolytic agent on h emostasis and study the role of hemostatic markers as predictors of clinical outcomes. Methods. In the present study, eighteen patients with acute myocardial in farction(AMI) received 1.5 or 2.0 million U nonspecific urokinase(UK), or 70～80 mg fibrin specific recombinant tissue plasminogen activator(rt PA)and did not use heparin until 8 hours after intravenous injection of the above agents. Eig ht patients with AMI and without thrombolytic therapy were enrolled as controls. Coagulant and thrombolytic activity markers included thrombin antithrombin Ⅲ complex (TAT), D dimer, fibrinogen (Fg), FMPV/Amax. All markers were determined before,immediately,1,2,4 and 8 hours after the administration of thrombolytic a gents respectively. Results. Molecular marker of thrombin generation——TAT showed an activated coa gulant state immediately after thrombolytic therapy. Level of TAT showed no sign ificant changes between every two observed phases in controls. However, level of TAT increased significantly from 4.95±1.75μg/L ( 4.63±1.37μg/L) to 14.71±3 .31μg/L ( 14.25±2.53μg/L) before and immediately after administration of thro mbolytic agents UK(or rt PA). There was significant difference between level of serum TAT of patients with and without thrombolytic therapy (P< 0.05). Patients achieving clinical reperfusion had lower TAT level than those failing in thromb olytic therapy, and higher FMPV/Amax level than controls. D dimer, a surrogate of thrombolytic activity increased markedly and Fg significantly declined afte r thrombolytic therapy(P< 0.05).Conclusions. Thrombin generation occurred in plasma in response to excess fibri nolysis induced by thrombolytic therapy. Both urokinase and rt PA had procoagul ant action. This transient activation of the coagulant system might contribute t o early reocclusion. These data provided the theoretical support for simultaneou s administration of anticoagulant therapy with thrombolytic agents. These result s also suggested that TAT might be useful in predicting clinical outcomes of p atients treated with thrombolytic therapy for AMI.展开更多
基金Supported by Grant from the National Scientific FoundationCommittee of China,30670606 from Chinese PLA Scientific Foundation of the Eleventh-Five programme,06MA263
文摘AIM:To present a series of cases with symptomatic acute extensive portal vein(PV)and superior mesenteric vein(SMV)thrombosis after splenectomy treated by transjugular intrahepatic approach catheter-directed thrombolysis. METHODS:A total of 6 patients with acute extensive PV-SMV thrombosis after splenectomy were treated by transjugular approach catheter-directed thrombolysis. The mean age of the patients was 41.2 years.After access to the portal system via the transjugular approach,pigtail catheter fragmentation of clots, local urokinase injection,and manual aspiration thrombectomy were used for the initial treatment of PV-SMV thrombosis,followed by continuous thrombolytic therapy via an indwelling infusion catheter in the SMV,which was performed for three to six days. Adequate anticoagulation was given during treatment, throughout hospitalization,and after discharge. RESULTS:Technical success was achieved in all 6 patients.Clinical improvement was seen in these patients within 12-24 h of the procedure.No complications were observed.The 6 patients were discharged 6-14 d(8±2.5 d)after admission.The mean duration of follow-up after hospital discharge was 40±16.5 mo.Ultrasound and contrast-enhanced computed tomography confirmed patency of the PV and SMV,and no recurrent episodes of PV-SMV thrombosis developed during the follow-up period. CONCLUSION:Catheter-directed thrombolysis via transjugular intrahepatic access is a safe and effective therapy for the management of patients with symptomatic acute extensive PV-SMV thrombosis.
文摘[Objective] To isolate and preserve a high-activity Douchi fibrinolytic enzyme producing strain from Douchi products. [Method] The Douchi flbrinolytic enzyme producing strain was screened on the selected medium prepared with self-made pork blood powder, the strain with the highest activity was screened out according to the size of hydrolysis cycle, and then preserved in LB medium. [ Rebait] A Douchi fibrinolytic enzyme producing strain with high thrombolytic activity was successfully screened out from the Douchi produced in Hunan, Guangdong and Jiangxi Prov- inces. [ Ceadusioe] The study lays foundation for the development of new-type thrombolytic drugs.
文摘The aim of this study is to test the patency rate and safety of the accelerated streptokinase dose regimen for coronary thrombolysis compared with the conventional one. One hundred and four patients enterring three hospitals up to 12 hours after the onset of definite acute myocardial infarction were randomizely treated with intravenous accelerated streptokinase dose regimen ( 1. 5 million units/30 min) (group A, 47 cases) and conventional dose regimen ( 1. 5 million units/60 min) (group B , 57 casese). The reperfusion rate of infarct-related arteries determined by clinical evidence of reperfusion was 76. 6% (36/47) in group A VS 61. 4% (35/57) in group B. There was significant difference in reperfusion rates among patients within 6 hours after the onset of chest pain : 87. 9% (29/33) in group A VS 67. 4 (29/43) in group B(P<0. 05 ). The incidence of mild bleeding , allergic reaction , hypotension was 12. 8 % ( 6/47 ) , 4. 3 % ( 2/47 ) , 12. 8 ( 6/47 ) respectively in group A vs 21. 1 ( 12/57 ) , 3. 5 (2/57) . 17. 5 % ( 10/57) respectively in group B. Compared to conventional dose regimen, intravenous accelerated streptokinase dose regimen for coronary thrombolysis seems to improve reperfusion rate markedly without increasing adverse events such as bleeding , allergic reaction and hypotension. It suggests that accelerated streptokinase therapy deserves more extensive investigation.
文摘Pulmonary thromboembolism （PTE） is a life-threatening condition with a high early mortality rate caused by acute right ventricular failure and cardiogenic shock. We report a series of three patients who presented with acute and subacute submassive PTE. They were suc-cessfully treated by simple catheter-based mechanical thrombectomy and intrapulmonary arterial thrombolysis. Mechanical fragmentation and aspiration of thrombus was performed by commonly used J-wire, multi-purpose and Judkin Right guiding catheters and this obviated the need of specific thrombectomy devices.
文摘To examine the procoagulant effects of thrombolytic agent on h emostasis and study the role of hemostatic markers as predictors of clinical outcomes. Methods. In the present study, eighteen patients with acute myocardial in farction(AMI) received 1.5 or 2.0 million U nonspecific urokinase(UK), or 70～80 mg fibrin specific recombinant tissue plasminogen activator(rt PA)and did not use heparin until 8 hours after intravenous injection of the above agents. Eig ht patients with AMI and without thrombolytic therapy were enrolled as controls. Coagulant and thrombolytic activity markers included thrombin antithrombin Ⅲ complex (TAT), D dimer, fibrinogen (Fg), FMPV/Amax. All markers were determined before,immediately,1,2,4 and 8 hours after the administration of thrombolytic a gents respectively. Results. Molecular marker of thrombin generation——TAT showed an activated coa gulant state immediately after thrombolytic therapy. Level of TAT showed no sign ificant changes between every two observed phases in controls. However, level of TAT increased significantly from 4.95±1.75μg/L ( 4.63±1.37μg/L) to 14.71±3 .31μg/L ( 14.25±2.53μg/L) before and immediately after administration of thro mbolytic agents UK(or rt PA). There was significant difference between level of serum TAT of patients with and without thrombolytic therapy (P< 0.05). Patients achieving clinical reperfusion had lower TAT level than those failing in thromb olytic therapy, and higher FMPV/Amax level than controls. D dimer, a surrogate of thrombolytic activity increased markedly and Fg significantly declined afte r thrombolytic therapy(P< 0.05).Conclusions. Thrombin generation occurred in plasma in response to excess fibri nolysis induced by thrombolytic therapy. Both urokinase and rt PA had procoagul ant action. This transient activation of the coagulant system might contribute t o early reocclusion. These data provided the theoretical support for simultaneou s administration of anticoagulant therapy with thrombolytic agents. These result s also suggested that TAT might be useful in predicting clinical outcomes of p atients treated with thrombolytic therapy for AMI.
