全反式维甲酸治疗急性早幼粒细胞白血病期间D-二聚体测定的临床意义

目的 探讨在全反式维甲酸 (ATRA)治疗急性早幼粒细胞白血病 (APL)前后弥漫性血管内凝血(DIC)发生率与D 二聚体含量的关系及意义。方法 应用ELISA法检测 30例APL患者 (包括 12例合并DIC患者 )发病时及应用ATRA治疗后D 二聚体水平的变化 ,并与正常对照组比较。结果 30例APL患者治疗前血浆D 二聚体水平 (2 .38± 0 .98mg/L)较正常对照组 (0 .2 5± 0 .0 9mg/L)明显升高 (P <0 .0 1) ,其中 12例并发DIC者(2 .5 2± 0 .12mg/L)明显高于 18例不并发DIC者 (2 .18± 0 .96mg/L)。结论 APL患者D 二聚体检测值随维甲酸治疗逐渐降低 ,并可预测ATRA治疗过程中DIC变化及预后。

EFFECT ON BLOOD CLOTTING AND FIBRINOLYSIS WITH ELECTRO-ACUPUNCTURE TREATMENTS AT "BAIHUI" AND "SHUIGU" ACUPOINTS FOR CEREBRAL INFARCTION IN RATS

Objective To investigate the effective mechanism of the treatments with electroacupuncture （EA） at ＂BǎiHuì＂ （GV20） and ＂ShuǐGōu＂ acupoints for cerebral infarction. Methods Forty rats were randomly divided into four groups as normal group （n = 10）, sham-operation group （n = 10）, model group （n = 10）, EA group （n = 10）. The acute cerebral infarction model in rats was developed by blocking the middle cerebral artery with an intraluminal thread. The contents of t-PA,PAI-1 ,D-D and Fib were estimated in each group. Results The contents of t-PA, PAI-1, D-D and Fib increased significantly （P〈0.01） in the model group as compared to the normal and sham-operation group. The contents of t-PA, PAI-1, D-D and Fib decreased significantly （P〈0.05-0.01） in the EA group as compared to the normal group. Conclusion The balance function of blood clotting and fibrinolysis were good and the cerebral abnormal blood was improved in EA group.

An extensive DeBakey type IIIb aortic dissection with massive right pleural effusion presenting as abdominal pain and acute anemia： particular case report

We describe the case of a 79-year-old male presented with sudden onset of abdominal pain and mild breathlessness, and complicated acute progressive anemia with haemoglobin which declined from 120 g/L to 70 g/L within five days. An urgent computed tomography an- giography showed acute thoracic aortic dissection, DeBakey type IIIb, a dissecting aneurysm in the proximal descending thoracic aorta start- ing immediately after the origin of the left subclavian artery and extending distally below the renal arteries with evidence of rupture into the right pleural cavity for massive pleural effusion. Plasma D-dimer, brain natriuretic peptide and C reactive protein level were elevated. Our case showed that D-dimer can be used as a ＇rule-out＇ test in patients with suspected aortic dissection. A raised BNP may exert a protective role through anti-inflammatory endothelial actions in the systemic circulation.

Effect of electroacupuncture at "Bǎihuì"(百会GV 20) and "Shuǐgōu"(水沟GV 26) acupoints on the contents of plasma D-dimer and fibrinogen in rats with acute cerebral infarction

Objective To investigate the mechanisms of electroacupuncture （EA） at ＂Baihui＂ （百会 GV 20） and ＂Shuigou＂ （水沟 GV 26） for treating cerebral infarction. Methods Forty healthy SD rats were randomly divided into model group （n = 10）, EA group （n = 10）, normal group （n = 10）, and sham operation group （n = 10）. The model of acute cerebral infarction was established by blocking the middle cerebral artery with an intraluminal thread. EA was applied at ＂Baihui＂ （百会 GV 20） and ＂Shuigou＂ （水沟GV 26） in the rats of EA group after the models were developed. The contents of D-dimer （D-D） and fibrinogen （Fib） were measured in each group. Results The contents of D-D and Fib increased signifi- cantly in model group as compared with normal and sham operation groups, respectively （P〈0.01）, and they decreased significantly in EA group as compared with model group （P〈0.01）. Conclusion EA can ob-viously decrease the contents of D-D and Fib, improve abnormal fibrinolysis, lower blood viscosity and ameliorate cerebral blood circulation in the rats with acute cerebral infarction.

Electrical stimulation of acupoint combinations against deep venous thrombosis in elderly bedridden patients after major surgery

OBJECTIVE:To compare the effects of electrical stimulation of different acupoint combinations among postoperative bedridden elderly patients on hemorheology and deep venous blood flow velocity and investigate the role of electrical stimulation against deep vein thrombosis(DVT).METHODS:From November 2010 to October 2011,a total of 160 elderly bedridden patients after major surgery were divided into the conventional care group,invigorating and promoting Qi group,blood-activating and damp-eliminating group,and acupoint-combination stimulation group.Whole blood viscosity,plasma viscosity,D-dimer levels,lower limb skin temperature,lower limb circumference,and flow velocities of the external iliac vein,femoral vein,popliteal vein,and deep calf veins in all patients were documented and compared among the four groups.RESULTS:Whole blood viscosity,plasma viscosity,D-dimer levels,and lower limb circumference were significantly reduced in the blood-activating and damp-eliminating group compared with the conventional care group(P<0.05) and were almost equal to those in the acupoint-combination stimulation group(P>0.05).Lower limb venous flow velocities were accelerated in the invigorating and promoting Qi group compared with the other groups,excluding the acupoint-combination stimulation group(P<0.05).CONCLUSION:Hemorheological indices in postoperative bedridden elderly patients were improved after combined electrical stimulation at Yinlingquan(SP 9) and Sanyinjiao(SP 6).Combined electrical stimulation at Zusanli(ST 36) and Taichong(LR 3),on the other hand,accelerated lower limb venous flow.