Inhibiting MMP13 Attenuates Deep Vein Thrombosis in a Mouse Model by Reducing the Expression of Pdpn

Objective:Matrix metalloproteinase 13(MMP13)is an extracellular matrix protease that affects the progression of atherosclerotic plaques and arterial thrombi by degrading collagens,modifying protein structures and regulating inflammatory responses,but its role in deep vein thrombosis(DVT)has not been determined.The purpose of this study was to investigate the potential effects of MMP13 and MMP13-related genes on the formation of DVT.Methods:We altered the expression level of MMP13 in vivo and conducted a transcriptome study to examine the expression and relationship between MMP13 and MMP13-related genes in a mouse model of DVT.After screening genes possibly related to MMP13 in DVT mice,the expression levels of candidate genes in human umbilical vein endothelial cells(HUVECs)and the venous wall were evaluated.The effect of MMP13 on platelet aggregation in HUVECs was investigated in vitro.Results:Among the differentially expressed genes,interleukin 1 beta,podoplanin(Pdpn),and factor VIII von Willebrand factor(F8VWF)were selected for analysis in mice.When MMP13 was inhibited,the expression level of PDPN decreased significantly in vitro.In HUVECs,overexpression of MMP13 led to an increase in the expression level of PDPN and induced platelet aggregation,while transfection of PDPN-siRNA weakened the ability of MMP13 to increase platelet aggregation.Conclusions:Inhibiting the expression of MMP13 could reduce the burden of DVT in mice.The mechanism involves downregulating the expression of Pdpn through MMP13,which could provide a novel gene target for DVT diagnosis and treatment.

Upper extremity deep vein thrombosis:An intensivist’s perspective

Upper extremity deep vein thrombosis(UEDVT)is less common than lower extremity DVT but is a cause of significant morbidity and mortality in intensive care unit patients.Increasing cancer incidence,prolonged life expectancy and increasing use of intravascular catheters and devices has led to an increased incidence of UEDVT.It is also associated with high rates of complications like pulmonary embolism,post-thrombotic syndrome and recurrent thrombosis.Clinical prediction scores and D-dimer may not be as useful in identifying UEDVT;hence,a high suspicion index is required for diagnosis.Doppler ultrasound is commonly employed for diagnosis,but other tests like computed tomography and magnetic resonance imaging venography may also be required in some patients.Contrast venography is rarely used in patients with clinical and ultrasound findings discrepancies.Anticoagulant therapy alone is sufficient in most patients,and thrombolysis and surgical decompression is seldom indicated.The outcome depends on the cause and underlying comorbidities.

Analysis of risk factors for postoperative deep vein thrombosis after craniotomy and nomogram model construction

BACKGROUND Deep vein thrombosis(DVT)of the lower extremity is one of the most common postoperative complications,especially after craniocerebral surgery.DVT may lead to pulmonary embolism,which has a devastating impact on patient prognosis.This study aimed to investigate the incidence and risk factors of DVT in the lower limbs following craniocerebral surgery.AIM To identify independent risk factors for the development of postoperative DVT and to develop an effective risk prediction model.METHODS The demographic and clinical data of 283 patients who underwent craniocerebral surgery between December 2021 and December 2022 were retrospectively analyzed.The independent risk factors for lower extremity DVT were identified by univariate and multivariate analyses.A nomogram was created to predict the likelihood of lower extremity DVT in patients who had undergone craniocerebral surgery.The efficacy of the prediction model was determined by receiver operating characteristic curve using the probability of lower extremity DVT for each sample.RESULTS Among all patients included in the analysis,47.7%developed lower extremity DVT following craniocerebral surgery.The risk of postoperative DVT was higher in those with a longer operative time,and patients with intraoperative intermittent pneumatic compression were less likely to develop postoperative DVT.CONCLUSION The incidence of lower extremity DVT following craniocerebral surgery is significant,highlighting the importance of identifying independent risk factors.Interventions such as the use of intermittent pneumatic compression during surgery may prevent the formation of postoperative DVT.

Biometric Finger Vein Recognition Using Evolutionary Algorithm with Deep Learning

In recent years,the demand for biometric-based human recog-nition methods has drastically increased to meet the privacy and security requirements.Palm prints,palm veins,finger veins,fingerprints,hand veins and other anatomic and behavioral features are utilized in the development of different biometric recognition techniques.Amongst the available biometric recognition techniques,Finger Vein Recognition(FVR)is a general technique that analyzes the patterns of finger veins to authenticate the individuals.Deep Learning(DL)-based techniques have gained immense attention in the recent years,since it accomplishes excellent outcomes in various challenging domains such as computer vision,speech detection and Natural Language Processing(NLP).This technique is a natural fit to overcome the ever-increasing biomet-ric detection problems and cell phone authentication issues in airport security techniques.The current study presents an Automated Biometric Finger Vein Recognition using Evolutionary Algorithm with Deep Learning(ABFVR-EADL)model.The presented ABFVR-EADL model aims to accomplish bio-metric recognition using the patterns of the finger veins.Initially,the presented ABFVR-EADL model employs the histogram equalization technique to pre-process the input images.For feature extraction,the Salp Swarm Algorithm(SSA)with Densely-connected Networks(DenseNet-201)model is exploited,showing the proposed method’s novelty.Finally,the Deep-Stacked Denoising Autoencoder(DSAE)is utilized for biometric recognition.The proposed ABFVR-EADL method was experimentally validated using the benchmark databases,and the outcomes confirmed the productive performance of the proposed ABFVR-EADL model over other DL models.

Outcome of Patients with Lower Limbs Deep Vein Thrombosis at the University Hospital of Brazzaville (The Republic of the Congo)

The aim of this study was to describe the characteristics of patients with deep vein thrombosis (DVT) of the pelvic limbs at the time of diagnosis, and their course after hospitalization, in order to improve the management of DVT in our context. This was a descriptive longitudinal study, based on cases of deep vein thrombosis recorded between 1 January 2015 and 30 September 2018, in the cardiology and internal medicine department of the Brazzaville University Hospital Centre. During the study period, 4678 patients were hospitalized, including 52 with DVT. Thirty-three were reassessed. The frequency of DVT was 1.1% and the average hospitalization rate was 13.9 cases/year. The 33 patients were divided into 20 women and 13 men (sex ratio: 0.65). The mean age of the patients was 51.4 ± 17.8 years (extremes: 16 and 85 years). The main aetiological factors were cancer (19.1%), sickle cell disease (3%) and HIV immunosuppression (3%). The predominant risk factors were: prolonged immobilization (42.9%), pregnancy, long travel and obesity in the same number of cases (n = 3, i.e. 14.2%). The DVT involved the left pelvic limb in 75.8% of cases. Anticoagulants were administered in all patients, and compression stockings were worn in 97% of cases. The mean time to re-evaluation was 10.9 ± 9.4 months (extremes: three and 35 months). The mean measurements of the limb where the thrombosis had occurred at diagnosis and reassessment showed a significant difference. Venous Doppler showed compressible veins (60.6%), varicosities (36.3%), incompressible veins (30.3%) and thrombus (21.2%). Complications were: post-phlebitic disease (42.4%), death (21.2%), pulmonary embolism (18.2%), recurrence (18.2%). The DVT remains relatively rare, and its conventional therapeutic management is satisfactory. Systematic venous Doppler ultrasound reassessment should enable patients at risk of recurrence to be identified.

Enlightenment of calcite veins in deep Ordovician Wufeng-Silurian Longmaxi shales fractures to migration and enrichment of shale gas in southern Sichuan Basin, SW China

The relationship between fracture calcite veins and shale gas enrichment in the deep Ordovician Wufeng Formation-Silurian Longmaxi Formation (Wufeng-Longmaxi) shales in southern Sichuan Basin was investigated through core and thin section observations, cathodoluminescence analysis, isotopic geochemistry analysis, fluid inclusion testing, and basin simulation. Tectonic fracture calcite veins mainly in the undulating part of the structure and non-tectonic fracture calcite veins are mainly formed in the gentle part of the structure. The latter, mainly induced by hydrocarbon generation, occurred at the stage of peak oil and gas generation, while the former turned up with the formation of Luzhou paleouplift during the Indosinian. Under the influence of hydrocarbon generation pressurization process, fractures were opened and closed frequently, and oil and gas episodic activities are recorded by veins. The formation pressure coefficient at the maximum paleodepth exceeds 2.0. The formation uplift stage after the Late Yanshanian is the key period for shale gas migration. Shale gas migrates along the bedding to the high part of the structure. The greater the structural fluctuation is, the more intense the shale gas migration activity is, and the loss is more. The gentler the formation is, the weaker the shale gas migration activity is, and the loss is less. The shale gas enrichment in the core of gentle anticlines and gentle synclines is relatively higher.

Analysis and Literature Review of Deep Vein Thrombosis Related Phlegmasia Cerulea Dolens Diagnosis in Critically Patients

Goal: The purpose of this research is to analyze the clinical characteristics, diagnosis, treatment, and prognosis of critical care patients with phlegmasia cerulea dolens (PCD) caused by deep vein thrombosis. Our goal is to improve both awareness and early diagnosis and treatment of rare clinical diseases. Furthermore, we aim to examine advancements in the diagnosis and treatment of deep vein thrombosis. Method: The clinical information of patients with PCD received in 2022 was subject to retrospective analysis. The author conducted a search of 191 publications with a focus on PCD, from January 2010 to July 2022, from databases such as the China National Knowledge Infrastructure (CNKI), Wanfang Data, PubMed, etc. The results were used to summarize the examinations, diagnostic criteria, and treatment progress of PCD patients. Additionally, the author conducted another search using keywords such as “Venous thromboembolism” and “Anticoagulant drugs” to summarize research progress in anticoagulant drugs and the treatment of VTE. The search was limited to relevant. Outcome: Six months prior to admission, the patient, a 68-year-old female, developed sunken edema and cyanosis in both her lower extremities and was diagnosed with lower extremity deep vein thrombosis complicated by PCD, lower extremity ischemic necrosis, and septicemia. This diagnosis was made using a combination of CT and lower extremity vascular ultrasound-related examinations, as well as a significantly elevated D-dimer value. Despite active treatment and aggressive measures, such as anti-infection, organ function maintenance, anticoagulation, and improvement of microcirculatory disorders, the patient’s family declined corresponding surgical treatment and interventional surgery for the lower extremity due to objective factors, and the patient ultimately succumbed to her illness. The clinical characteristics of this patient were similar to those of the 14 cases of PCD reported by Xie Fei et al. in 2022. Conclusion: For patients with malignancy, it is crucial to start anticoagulation and physical prevention of DVT early on. Patients with DVT complicated by PCD have a variety of surgical options available to them, including surgical embolization or PMT (percutaneous mechanical thrombus ablation), CDT (catheter contact thrombolysis), and fascial ventriculotomy decompression [1]. Additionally, it may be necessary to place an inferior venous filter. Although the incidence of this disease is low accounting for approximately 5% of all patients with iliofemoral deep vein thrombosis [2], the prognosis is poor, as the mortality rate can reach up to 40% - 60% due to venous gangrene, with an overall mortality rate of 20% - 40% [3]. To increase the survival rate, it is important to diagnose and treat this disease as early as possible.

Kelp Fucoidans Facilitate Vascular Recanalization via Inhibiting Excessive Activation of Platelet in Deep Venous Thrombosis Model of Mouse

This study was carried out explore the mechanism underlying the inhibition of platelet activation by kelp fucoidans in deep venous thrombosis(DVT)mouse.In the control and sham mice,the walls of deep vein were regular and smooth with intact intima,myometrium and adventitia.The blood vessel was wrapped with the tissue and there was no thrombosis in the lumen.In the DVT model,the wall was uneven with thicken intima,myometrium and adventitia.After treated with fucoidans LF1 and LF2,the thrombus was dissolved and the blood vessel was recanalized.Compared with the control group,the ROS content,ET-1 and VWF content and the expression of PKC-βand NF-κB in the model were significantly higher(P<0.05);these levels were significantly reduced following treatments with LF2 and LF1.Compared with H_(2)O_(2)treated-HUVECs,combined LF1 and LF2 treatment resulted in significant decrease in the expression of PKC-β,NF-κB,VWF and TM protein(P<0.05).It is clear that LF1 and LF2 reduces DVT-induced ET-1,VWF and TM expressions and production of ROS,thus inhibiting the activation of PKC-β/NF-κB signal pathway and the activation of coagulation system and ultimately reducing the formation of venous thrombus.

Intelligent diagnosis of retinal vein occlusion based on color fundus photographs

AIM:To develop an artificial intelligence(AI)diagnosis model based on deep learning(DL)algorithm to diagnose different types of retinal vein occlusion(RVO)by recognizing color fundus photographs(CFPs).METHODS:Totally 914 CFPs of healthy people and patients with RVO were collected as experimental data sets,and used to train,verify and test the diagnostic model of RVO.All the images were divided into four categories[normal,central retinal vein occlusion(CRVO),branch retinal vein occlusion(BRVO),and macular retinal vein occlusion(MRVO)]by three fundus disease experts.Swin Transformer was used to build the RVO diagnosis model,and different types of RVO diagnosis experiments were conducted.The model’s performance was compared to that of the experts.RESULTS:The accuracy of the model in the diagnosis of normal,CRVO,BRVO,and MRVO reached 1.000,0.978,0.957,and 0.978;the specificity reached 1.000,0.986,0.982,and 0.976;the sensitivity reached 1.000,0.955,0.917,and 1.000;the F1-Sore reached 1.000,0.9550.943,and 0.887 respectively.In addition,the area under curve of normal,CRVO,BRVO,and MRVO diagnosed by the diagnostic model were 1.000,0.900,0.959 and 0.970,respectively.The diagnostic results were highly consistent with those of fundus disease experts,and the diagnostic performance was superior.CONCLUSION:The diagnostic model developed in this study can well diagnose different types of RVO,effectively relieve the work pressure of clinicians,and provide help for the follow-up clinical diagnosis and treatment of RVO patients.

Application of the “Three Threes” Method in Clinical Teaching of Internal Jugular Vein Puncture

Objective: To clarify the role of the “Three Threes” method in clinical teaching of internal jugular vein puncture and explore improvements in teaching methods. Methods: A doctor was assigned to the induction room of the Second Affiliated Hospital of Naval Medical University (Shanghai Changzheng Hospital) for two months. The time required for catheterization, the first puncture success rate, and occurrence of puncture-related complications were compared before and after learning the “Three Threes” method. Results: Using the “Three Threes” method reduced the catheterization time by 43%, increased the first puncture success rate by 17%, and led to fewer puncture-related complications. Conclusion: The application of the “Three Threes” method not only improves the success rate of internal jugular vein puncture but also reduces complications, making it easier for students to master the technique.

Deep-learning classifier with ultrawide-field fundus ophthalmoscopy for detecting branch retinal vein occlusion

AIM: To investigate and compare the efficacy of two machine-learning technologies with deep-learning(DL) and support vector machine(SVM) for the detection of branch retinal vein occlusion(BRVO) using ultrawide-field fundus images. METHODS: This study included 237 images from 236 patients with BRVO with a mean±standard deviation of age 66.3±10.6 y and 229 images from 176 non-BRVO healthy subjects with a mean age of 64.9±9.4 y. Training was conducted using a deep convolutional neural network using ultrawide-field fundus images to construct the DL model. The sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV) and area under the curve(AUC) were calculated to compare the diagnostic abilities of the DL and SVM models. RESULTS: For the DL model, the sensitivity, specificity, PPV, NPV and AUC for diagnosing BRVO was 94.0%(95%CI: 93.8%-98.8%), 97.0%(95%CI: 89.7%-96.4%), 96.5%(95%CI: 94.3%-98.7%), 93.2%(95%CI: 90.5%-96.0%) and 0.976(95%CI: 0.960-0.993), respectively. In contrast, for the SVM model, these values were 80.5%(95%CI: 77.8%-87.9%), 84.3%(95%CI: 75.8%-86.1%), 83.5%(95%CI: 78.4%-88.6%), 75.2%(95%CI: 72.1%-78.3%) and 0.857(95%CI: 0.811-0.903), respectively. The DL model outperformed the SVM model in all the aforementioned parameters(P<0.001). CONCLUSION: These results indicate that the combination of the DL model and ultrawide-field fundus ophthalmoscopy may distinguish between healthy and BRVO eyes with a high level of accuracy. The proposed combination may be used for automatically diagnosing BRVO in patients residing in remote areas lacking access to an ophthalmic medical center.

Pulmonary embolism and deep vein thrombosis caused by nitrous oxide abuse: A case report

BACKGROUND Nitrous oxide(N2O)has gained increasing popularity as a recreational drug,causing hallucinations,excitation,and psychological dependence.However,side effects have been reported in recent years.Our case report proposes a correlation among N2O,pulmonary embolism(PE),and deep vein thrombosis(DVT)and emphasizes the role of homocysteine(Hcy)in thrombotic events.CASE SUMMARY A 29-year-old man with long-term N2O abuse sought evaluation after acute chest pain.A diagnostic workup revealed PE,DVT,and hyperhomocysteinemia.The patient was successfully treated with thrombolytic and anticoagulant therapy.Moreover,his Hcy level decreased and returned to normal after Hcy-lowering therapy.CONCLUSION Chronic N2O abuse might increase the risk of PE and DVT,although there have been few studies previously.

Can emergency physicians perform extended compression ultrasound for the diagnosis of lower extremity deep vein thrombosis?

BACKGROUND:Current point-of-care ultrasound protocols in the evaluation of lower extremity deep vein thrombosis (DVT) can miss isolated femoral vein clots.Extended compression ultrasound (ECUS) includes evaluation of the femoral vein from the femoral vein/deep femoral vein bifurcation to the adductor canal.Our objective is to determine if emergency physicians (EPs) can learn ECUS for lower extremity DVT evaluation after a focused training session.METHODS:Prospective study at an urban academic center.Participants with varied ultrasound experience received instruction in ECUS prior to evaluation.Two live models with varied levels of difficult sonographic anatomy were intentionally chosen for the evaluation.Each participant scanned both models.Pre-and post-study surveys were completed.RESULTS:A total of 96 ultrasound examinations were performed by 48 participants (11 attendings and 37 residents).Participants' assessment scores averaged 95.8% (95% CI 93.3%-98.3%) on the easier anatomy live model and averaged 92.3% (95% CI 88.4%-96.2%) on the difficult anatomy model.There were no statistically significant differences between attendings and residents.On the model with easier anatomy,all but 1 participant identified and compressed the proximal femoral vein successfully,and all participants identified and compressed the mid and distal femoral vein.With the difficult anatomy,97.9% (95% CI93.8%-102%) identified and compressed the proximal femoral vein,whereas 93.8% (95% CI 86.9%-100.6%) identified and compressed the mid femoral vein,and 91.7% (95% CI83.9%-99.5%) identified and compressed the distal femoral vein.CONCLUSION:EPs at our institution were able to perform ECUS with good reproducibility after a focused training session.

Comparison of Clinical Results in Deep Vein Thrombosis of Total Knee Arthroplasty with Rivaroxaban and Dalteparin Sodium

This study was intended to investigate into the incidence rates of deep vein thrombosis (DVT) in patients who used prophylactic antithrombotic medications after total knee arthroplasty (TKA), and to compare clinical results in groups treated with Rivaroxaban versus Dalteparin sodium as prophylactic antithrombotic medications. This prospective study was performed in 300 patients who underwent TKA between November 2011 and December 2012. The prophylactic therapy was given to 150 patients in Rivaroxaban group and Dalteparin sodium group, respectively. In addition, intermittent compression pump and stocking were used in all the groups immediately after TKA. In order to determine the incidence of DVT, color Doppler ultrasonography, D-dimer, and clinical symptom examination were conducted. There were 17 cases (11.3%) of DVT in Rivaroxaban group and 18 cases (12.0%) of DVT in Dalteparin sodium group after TKA, and no significant difference was seen between both groups. Between patients with DVT and those without DVT after TKA at 4 days in both groups, there was a significant difference in the swelling indices. Moreover, a significant difference was observed in the evaluation of bruise. The early signs of DVT after TKA are unknown, however, some initial clinical signs such as swelling have been observed. After using the said prophylactic drugs, the lower incidence of DVT was seen, and there was no difference between the types of drugs. Pharmacological therapy (either Rivaroxaban or Dalteparin sodium) after TKA is considered effective for DVT prevention. There is also a need to consider constant monitoring of clinical symptoms.

IOP-lowering effects for the application of human umbilical vein in non-penetrating deep sclerostomy in rabbits

AIM: To estimate the effects of human umbilical vein (HUV) implanted under the sclera of glaucoma model on intraocular pressure (IOP) lowering and to investigate its related mechanisms METHODS: A total of 20 human umbilical veins (HUV) were collected from healthy fetus umbilical core. After the establishment of glaucoma model in rabbits, human freeze-dried umbilical vein was implanted under the sclera during NPDS, while for control group, sclerostomy was performed without implant. The formation of the filtration bleb and TOP were detected every 24 hours before surgery and on day 3, 7, 10 and 14 after surgery. Handheld pen-type Tono-pen II tonometer was used to measure TOP after topical anesthesia treatment. Each measurement has three duplicates. The incision recovery, filtration, conjunctiva congestion and anterior chamber inflammation were observed everyday after surgery. RESULTS: IOP was decreased dramatically with less inflammation than traditional sclerostomies with the application of HUV. The significant differences of IOP between the NPDS with and without HUV implant groups were shown up from 10 days after surgery. The average TOP in NPDS without HUV implant was 14.25mmHg, while for NPDS with HUV implant group, it was 12.30mmHg. This structure of filtration bleb, which allowed the aqueous humor to leave the eye, was formed for any type of surgery. However, 1-2 weeks later, filtration bleb was still Existed in the group of sclerostomy with HUV implant and more stable than that of the surgery without HUV implant. Histological observations were performed on day 3, 7 and 14 after surgery. For the eyes under sclerostomy with HUV implant, HUV lumina was shown up on 3 days after surgery with few fibroblast cells near the sclera. On 7 days after surgery, HUV lumina was stably maintained but with obvious fibroblast cells and inflammatory cell. On 14 days after surgery, HUV lumina was still clearly observed but with scarring formation, which suggests that the IOP lowering effects might result from an effective drainage structure formation. CONCLUSION: HUV might be an alternative material to make the drainage pathway for non-penetrating deep sclerostomy.

Small RNA deep sequencing reveals full-length genome of Citrus yellow vein clearing virus in Chongqing,China

To identity the potential pathogen associated with the yellow vein clearing symptom on lemon trees, the profiles of virus-de- rived small interfering RNAs from citrus samples were obtained and analyzed by deep sequencing method in this study. Twenty-seven contigs almost cover the full length genome of Citrus yellow vein clearing virus （CYVCV） isolate YN were obtained using the small RNA deep sequencing technology. Analysis showed that this isolate CQ shared the highest nucleotide identity with isolate Y1 （JX040635） and YN （KP313242）, both of which belong to the genus Mandarivirus in the family Alphaflexiviridae. Mapping analysis of viral-derived siRNA （vsiRNA） profiles revealed an uneven distribution pattern of their generations along both positive and negative genome strands, and 22- and 21-nt vsiRNAs ranked the majority. BLAST against viroids and other viral databases confirmed that this sample was single-infected only by CYVCV, which indicated that CYVCV was the exact causal agent for the yellow clearing symptom occurring on lemon. This is the first CYVCV isolate detected in Chongqing and the second in China. This result could provide a molecular basis for the investigation of citrus viral diseases to protect citrus health in this region.

Clinical effectiveness of a pneumatic compression device combined with low-molecular-weight heparin for the prevention of deep vein thrombosis in trauma patients:A single-center retrospective cohort study

BACKGROUND:To investigate the clinical effectiveness of a pneumatic compression device(PCD)combined with low-molecular-weight heparin(LMWH)for the prevention and treatment of deep vein thrombosis(DVT)in trauma patients.METHODS:This study retrospectively analyzed 286 patients with mild craniocerebral injury and clavicular fractures admitted to our department from January 2016 to February 2020.Patients treated with only LMWH served as the control group,and patients treated with a PCD combined with LMWH as the observation group.The incidence of DVT,postoperative changes in the visual analogue scale(VAS)score,and coagulation function were observed and compared between the two groups.Excluding the influence of other single factors,binary logistic regression analysis was used to evaluate the use of a PCD in the patient’s postoperative coagulation function.RESULTS:After excluding 34 patients who did not meet the inclusion criteria,252 patients were were included.The incidence of DVT in the observation group was significantly lower than that in the control group(5.6%vs.15.1%,χ^(2)=4.605,P<0.05).The postoperative VAS scores of the two groups were lower than those before surgery(P<0.05).The coagulation function of the observation group was significantly higher than that of the control group,with a better combined anticoagulant effect(P<0.05).There were no significant differences between the two groups in preoperative or postoperative Glasgow Coma Scale scores,intraoperative blood loss,postoperative infection rate,or length of hospital stay(P>0.05).According to logistic regression analysis,the postoperative risk of DVT in patients who received LMWH alone was 1.764 times that of patients who received LMWH+PCD(P<0.05).The area under the receiver operating characteristic(AUROC)curve of partial thromboplastin time(APTT)and platelet(PLT)were greater than 0.5,indicating that they were the influence indicators of adding PCD to prevent DVT.Excluding the influence of other variables,LMWH+PCD effectively improved the coagulation function of patients.CONCLUSIONS:Compared with LMWH alone,LMWH+PCD could improve blood rheology and coagulation function in patients with traumatic brain injury and clavicular fracture,reduce the incidence of DVT,shorten the length of hospital stay,and improve the clinical effectiveness of treatment.

Development and validation of a prediction model for deep vein thrombosis in older non-mild acute pancreatitis patients

BACKGROUND Deep vein thrombosis(DVT)may cause pulmonary embolus,leading to late deaths.The systemic inflammatory and hypercoagulable state of moderate and severe acute pancreatitis(non-mild acute pancreatitis,NMAP)patients may contribute to the development of venous thromboembolism.Accurate prediction of DVT is conducive to clinical decisions.AIM To develop and validate a potential new prediction nomogram model for the occurrence of DVT in NMAP.METHODS NMAP patient admission between 2013.1.1 and 2018.12.31 at the West China Hospital of Sichuan University was collected.A total of 220 patients formed the training set for nomogram development,and a validation set was constructed using bootstrapping with 100 resamplings.Univariate and multivariate logistic regression analyses were used to estimate independent risk factors associated with DVT.The independent risk factors were included in the nomogram.The accuracy and utility of the nomogram were evaluated by calibration curve and decision curve analysis,respectively.RESULTS A total of 220 NMAP patients over 60 years old were enrolled for this analysis.DVT was detected in 80(36.4%)patients.The final nomogram included age,sex,surgery times,D-dimer,neutrophils,any organ failure,blood culture,and classification.This model achieved good concordance indexes of 0.827(95%CI:0.769-0.885)and 0.803(95%CI:0.743-0.860)in the training and validation sets,respectively.CONCLUSION We developed and validated a prediction nomogram model for DVT in older patients with NMAP.This may help guide doctors in making sound decisions regarding the administration of DVT prophylaxis.

Pulmonary Embolism and Deep Vein Thrombosis in a Woman Taking Contraceptives and with Unhealthy Life Habit:a Case Report

ORAL contraceptives are widely used to prevent pregnancy.A number of studies have demonstrated the increased risk of venous thromboembolism in women taking oral contraceptives.1,2 Pulmonary embolism(PE) and deep vein thrombosis(DVT) are two clinical presentations of

The Clinical Characteristics of Combined Deep Vein Thrombosis Prophylaxis of Rivaroxaban and Mechanical Therapy after Total Knee Replacement Arthroplasty

Purpose: To investigate the clinical characteristics of combined prophylaxis of rivaroxaban (Xarelto?) and mechanical therapy (foot sole pump, antiembolism stocking) after total knee replacement arthroplasty, for prevention of deep vein thrombosis (DVT). Materials and Methods: The subjects of this study were 110 patients who underwent total knee replacement arthroplasty (TKA) between November 2011 and May 2012, and were prospectively evaluated. They consisted of 13 men (11.8%) and 97 women (88.2%) with the mean age of 68.7 years (±7.9). All of the patients received 10 mg of rivaroxaban once daily for 14 days from Day 1 postoperatively, and used an intermittent pneumatic compression (IPC) pump and compression stockings immediately after the operation. To determine the presence of postoperative DVT, clinical symptoms examination, D-dimer test, color Doppler ultrasound imaging were performed to analyze the risk factors of DVT events. Results: There were a total of 13 patients (11.8%) with DVT in the distal lower limbs among the entire 110 patients. At Day 4 after the operation, a statistically significant difference was seen only in femoral swelling of several clinical symptoms between DVT group and non-DVT group (p = 0.043). D-dimer tests showed no statistically significant difference between the two groups, however with the boundary value of 0.3 mg/L, diagnostic sensitivity, specificity, positive predictability and negative predictability were equivalent to 100%, 8.2%, 12.7% and 100%, respectively. There was no significant difference between the two groups in terms of well-known risk factors including age, gender, obesity, hypertension, diabetes, smoking, and anesthesia method, and no case of pulmonary embolism was observed. Conclusion: A combination of pharmacological therapy (rivaroxaban, Xarelto?) and mechanical therapy (foot sole pump system) after TKA is considered effective for DVT prevention.