Hemorrhage is the leading cause of preventable death in combat trauma and the secondary cause of death in civilian trauma.A significant number of deaths due to hemorrhage occur before and in the first hour after hospi...Hemorrhage is the leading cause of preventable death in combat trauma and the secondary cause of death in civilian trauma.A significant number of deaths due to hemorrhage occur before and in the first hour after hospital arrival.A literature search was performed through PubMed,Scopus,and Institute of Scientific Information databases for English language articles using terms relating to hemostatic agents,prehospital,battlefield or combat dressings,and prehospital hemostatic resuscitation,followed by cross-reference searching.Abstracts were screened to determine relevance and whether appropriate further review of the original articles was warranted.Based on these findings,this paper provides a review of a variety of hemostatic agents ranging from clinically approved products for human use to newly developed concepts with great potential for use in prehospital settings.These hemostatic agents can be administered either systemically or locally to stop bleeding through different mechanisms of action.Comparisons of current hemostatic products and further directions for prehospital hemorrhage control are also discussed.展开更多
BACKGROUND:Uncontrolled bleeding is the first leading cause of preventable death in the battlefield and the 2nd cause of mortality in civil accidents.Incompressible hemorrhage control is among the interventions that d...BACKGROUND:Uncontrolled bleeding is the first leading cause of preventable death in the battlefield and the 2nd cause of mortality in civil accidents.Incompressible hemorrhage control is among the interventions that drastically increase the survival rate in wound individuals.We have previously shown that a certain mixture of bentonite and zeolite minerals can significantly decrease the bleeding in rats.METHODS:In this study,nine healthy hybrid dogs were selected and after induction of anesthesia with ether,either arterial puncture by a needle or arteriotomy was performed on both groin regions of the dogs.For control arteries(either the right or left femoral artery),only pressure by sterilized gauze was performed,while for the femoral arteries of the opposite side,our invented hemostatic agent,namely CoolClot,was topically used before applying the pressure.In the second stage of the study,to assess the coagulation time,blood samples were collected from 10 volunteer students.RESULTS:CoolClot significantly decreased the bleeding time in animals whose femoral arteries were cut or punctured.In the human phase of the study,the mean coagulation time in control blood samples was 253.4+44.1 seconds,whereas it was 149.5+50.0,162.3±74.6 and 143.4±114.6seconds,respectively in blood samples treated with bentonite,zeolite and CoolClot(P<0.05).CONCLUSIONS:As controlling bleeding after a life-threatening arterial damage is critical for increasing the chance of survival,the results obtained in this study indicate the significant efficacy of CoolClot in shortening the bleeding time.Our experiments also indicate that CoolClot can significantly reduce the clotting time in human blood samples.展开更多
Atopic dermatitis is a chronic, relapsing and extremely pruritic eczematous disease which commonly affects children. The standard management consists of a combination of anti-inflammatory drugs in adjunctive with skin...Atopic dermatitis is a chronic, relapsing and extremely pruritic eczematous disease which commonly affects children. The standard management consists of a combination of anti-inflammatory drugs in adjunctive with skin care management particular moisturizer application. A concern for the side effects associated with long term use of corticosteroids has also been considered. There has been an emerging interest in moisturizer containing non-steroidal anti-inflammatory agents such as herbal extracts, vitamins, mineral and lipids. The in vitro and the in vivo studies of each agent were reviewed. The clinical study on the efficacy of moisturizers containing these agents were also demonstrated including the author's studies and clinicalexperience. These moisturizers might be considered as an alternative treatment in acute flare of mild to moderate atopic dermatitis.展开更多
Severe bleeding is a common problem and a main cause of death in a medical setting,including surgery,trauma,congenital and acquired abnormalities of hemostasis,fulminant hepatic failure,and gastrointestinal bleeding.I...Severe bleeding is a common problem and a main cause of death in a medical setting,including surgery,trauma,congenital and acquired abnormalities of hemostasis,fulminant hepatic failure,and gastrointestinal bleeding.It has been estimated that rxcessive blood loss may contribute to approximately 30% of trauma-related deaths.Bleeding in critical locations,especially intracerebral hemorrhage,pose also a major clinical challenge.Severe bleeding often needs blood transfusion.In many patients with abnormalities of hemostasis,bleeding can be effectively corrected by replacing the defective components of the hemostatic system,of which the most widely used are factor Ⅷ concentrations and recombinant factor Ⅷ products for hemophilia A treatment,prothrombin complex concentrates and recombinant factor Ⅸ for hemophilia B treatment,and fibrinogen or cryoprecipitate for afibrinogenemia.On the other hand,all the cases of excessive bleeding require pharmacologic strategies of hemostatic agents to minimize blood loss.展开更多
AIM To investigate the effect of Boschniakiarossica（BR）extract on expression of GST-P,p53 and p21<sup>ras</sup>proteins in early stage of chemicalhepatocarcinogenesis in rats and its anti-inflammatory ac...AIM To investigate the effect of Boschniakiarossica（BR）extract on expression of GST-P,p53 and p21<sup>ras</sup>proteins in early stage of chemicalhepatocarcinogenesis in rats and its anti-inflammatory activities.METHODS The expression of tumor marker-placental form glutathione S-transferase（GST-P）,p53 and p21<sup>ras</sup>proteins were investigated byimmunohistochemical techniques and ABCmethod.Anti-inflammatory activities of BR werestudied by xylene and croton oil-induced mouseear edema,carrageenin,histamine and hotscald-induced rat pow edema,adjuvant-inducedrat arthritis and cotton pellet-induced mousegranuloma formation methods.RESULTS The 500 mg/kg of BR-H<sub>2</sub>O extractfractionated from BR-Methanol extract hadinhibitory effect on the formation of DEN-inducedGST-P-positive foci in rat liver（GST-P stainingwas 78% positive in DEN+AAF group vs 20%positive in DEN+AAF+BR group,P【0.05）andthe expression of mutant p53 and p21<sup>ras</sup>proteinwas lower than that of hepatic preneoplasticlesions（33% and 22% positive respectively inDEN+AAF group vs negative in DEN+AAF+BRgroup）.Both CH<sub>2</sub>Cl<sub>2</sub> and H<sub>2</sub>O extracts from BRhad anti-inflamatory effect in xylene and crotonoil-induced mouse ear edema（inhibitory rateswere 26%-29% and 35%-59%,respectively）. BR-H<sub>2</sub>O extract exhibited inhibitory effect incarrageenin,histamine and hot scald-inducedhind paw edema and adjuvant-induced arthritis inrats and cotton pellet-induced granulomaformation in mice.CONCLUSION BR extract exhibited inhibitory effect on formation of preneoplastic hepatic foci in early stage of rat chemical hepato-carcinogenesis. Both CH<sub>2</sub>CI<sub>2</sub> and H<sub>2</sub>O extracts from BR exerted anti-inflammatory effect in rats and mice.展开更多
Directional migration of leukocytes is indispensable to innate immunity for host defense. However, recruitment of leukocytes to a site of tissue injury also constitutes a leading cause for inflammatory responses. Mech...Directional migration of leukocytes is indispensable to innate immunity for host defense. However, recruitment of leukocytes to a site of tissue injury also constitutes a leading cause for inflammatory responses. Mechanistically, it involves a cascade of cellular events precisely regulated by temporal and spatial presentation of a repertoire of molecules in the migrating leukocytes and their surroundings (microenvironments). Here I will summarize the emerging evidence that has shed lights on the underlying molecular mechanism for directional migration of leukocytes, which has guided the therapeutical development for innovative anti-inflammatory medicines.展开更多
This novel study identifi es the effective anti-inflammatory phenolic compounds in dandelion and provides mechanistic insights into their interactions with receptor proteins(toll-like receptor 4,TLR4;co-receptor myelo...This novel study identifi es the effective anti-inflammatory phenolic compounds in dandelion and provides mechanistic insights into their interactions with receptor proteins(toll-like receptor 4,TLR4;co-receptor myeloid differentiation protein-2,MD-2)using UHPLC-ESI-MS/MS,lipopolysaccharide(LPS)-stimulated THP-1 cell line,fluorescence quenching and anisotropy,molecular docking(single ligand and multi-ligand docking)and molecular dynamics simulation.A 50%aqueous methanol extract had a greater anti-inflammatory effect and higher chicoric acid content,compared with the 100%water and 100%methanol extracts.Chicoric acid,chlorogenic acid,methylophiopogonone A,caffeic acid,gallic acid monohydrate and 4’-O-demethylbroussonin A had relatively high binding energies and contents in all extracts.Chicoric acid competed with chlorogenic acid,4’-O-demethylbroussonin A and quercetin for MD-2.Among dandelion’s phenolics,chicoric acid most effectively hindered TLR4-MD-2 complex formation,with a quenching constant of 0.62×10^(6) L/mol for MD-2 or TLR4 at 320 K,and binding energies of-6.87 and-5.97 kcal/mol,respectively,for MD-2 and TLR4.展开更多
Background: Postoperative hemorrhage remains an uncommon but potentially life-threatening complication of thyroid surgery. The aim of this case-controlled study was to compare the effectiveness of PerClot® hemo...Background: Postoperative hemorrhage remains an uncommon but potentially life-threatening complication of thyroid surgery. The aim of this case-controlled study was to compare the effectiveness of PerClot® hemostatic agent with hemostasis by conventional technique (HCT) in thyroid surgery. Methods: The thyroid resection was performed from November 2009 to February 2010. Exclusion criteria were applied. There were 30 patients in the HCT group and 30 patients in the PerClot® group. The outcome parameters were postoperative bleeding, the drainage volume 24 hours postoperatively and adverse events according to PerClot®. Results: There was no post-operative hemorrhage in both groups. We found no significant difference between the control andPerClot® group with regard to total drainage volume after 24 h (51 ml ± 36.9 control group/53 ml ± 39.5 PerClot® group (p = 0.79)). There were no adverse events in the PerClot® group. Conclusions: Routine use of PerClot® hemostatic agent has no advantage over conventional hemostasis technique (HCT) in thyroid surgery. In addition, PerClot®?is safe and well tolerated.展开更多
Non-variceal upper gastrointestinal(GI)bleeding is a significant cause of morbidity and mortality.Traditionally,through-the-scope(TTS)clips,thermal therapy,and injection therapies are used to treat GI bleeding.In this...Non-variceal upper gastrointestinal(GI)bleeding is a significant cause of morbidity and mortality.Traditionally,through-the-scope(TTS)clips,thermal therapy,and injection therapies are used to treat GI bleeding.In this review,we provide an overview of novel endoscopic treatments that can be used to achieve hemostasis.Specifically,we discuss the efficacy and applicability of over-thescope clips,hemostatic agents,TTS doppler ultrasound,and endoscopic ultrasound,each of which offer an effective method of reducing rates of GI rebleeding.展开更多
To control capillary bleeding, surgeons may use absorbable hemostatic agents, such as Surgicel® and TachoSil®. Due to their slow resorption, their persistence in situ can have a negative impact on tissue rep...To control capillary bleeding, surgeons may use absorbable hemostatic agents, such as Surgicel® and TachoSil®. Due to their slow resorption, their persistence in situ can have a negative impact on tissue repair in the resected organ. To avoid complications and obtain a hemostatic agent that promotes tissue repair, a zinc-supplemented calcium alginate compress was developed: HEMO-IONIC®. This compress is non-absorbable and is therefore removed once hemostasis has been achieved. After demonstrating the hemostatic efficacy and stability of the blood clot obtained with HEMO-IONIC, the impact of Surgicel, TachoSil, and HEMO-IONIC on cell activation and tissue repair were compared (i) in vitro on endothelial cells, which are essential to tissue repair, and (ii) in vivo in a mouse skin excision model. In vitro, only HEMO-IONIC maintained the phenotypic and functional properties of endothelial cells and induced their migration. In comparison, Surgicel was found to be highly cytotoxic, and TachoSil inhibited endothelial cell migration. In vivo, only HEMO-IONIC increased angiogenesis, the recruitment of cells essential to tissue repair (macrophages, fibroblasts, and epithelial cells), and accelerated maturation of the extracellular matrix. These results demonstrate that a zinc-supplemented calcium alginate, HEMO-IONIC, applied for 10 min at the end of surgery and then removed has a long-term positive effect on all phases of tissue repair.展开更多
基金Canadian Forces Health Services and Defence Research and Development Canada for their support
文摘Hemorrhage is the leading cause of preventable death in combat trauma and the secondary cause of death in civilian trauma.A significant number of deaths due to hemorrhage occur before and in the first hour after hospital arrival.A literature search was performed through PubMed,Scopus,and Institute of Scientific Information databases for English language articles using terms relating to hemostatic agents,prehospital,battlefield or combat dressings,and prehospital hemostatic resuscitation,followed by cross-reference searching.Abstracts were screened to determine relevance and whether appropriate further review of the original articles was warranted.Based on these findings,this paper provides a review of a variety of hemostatic agents ranging from clinically approved products for human use to newly developed concepts with great potential for use in prehospital settings.These hemostatic agents can be administered either systemically or locally to stop bleeding through different mechanisms of action.Comparisons of current hemostatic products and further directions for prehospital hemorrhage control are also discussed.
基金supported by the Center for Research in Radiation Sciences(CRRS),Shiraz University of Medical Sciences(SUMS)
文摘BACKGROUND:Uncontrolled bleeding is the first leading cause of preventable death in the battlefield and the 2nd cause of mortality in civil accidents.Incompressible hemorrhage control is among the interventions that drastically increase the survival rate in wound individuals.We have previously shown that a certain mixture of bentonite and zeolite minerals can significantly decrease the bleeding in rats.METHODS:In this study,nine healthy hybrid dogs were selected and after induction of anesthesia with ether,either arterial puncture by a needle or arteriotomy was performed on both groin regions of the dogs.For control arteries(either the right or left femoral artery),only pressure by sterilized gauze was performed,while for the femoral arteries of the opposite side,our invented hemostatic agent,namely CoolClot,was topically used before applying the pressure.In the second stage of the study,to assess the coagulation time,blood samples were collected from 10 volunteer students.RESULTS:CoolClot significantly decreased the bleeding time in animals whose femoral arteries were cut or punctured.In the human phase of the study,the mean coagulation time in control blood samples was 253.4+44.1 seconds,whereas it was 149.5+50.0,162.3±74.6 and 143.4±114.6seconds,respectively in blood samples treated with bentonite,zeolite and CoolClot(P<0.05).CONCLUSIONS:As controlling bleeding after a life-threatening arterial damage is critical for increasing the chance of survival,the results obtained in this study indicate the significant efficacy of CoolClot in shortening the bleeding time.Our experiments also indicate that CoolClot can significantly reduce the clotting time in human blood samples.
文摘Atopic dermatitis is a chronic, relapsing and extremely pruritic eczematous disease which commonly affects children. The standard management consists of a combination of anti-inflammatory drugs in adjunctive with skin care management particular moisturizer application. A concern for the side effects associated with long term use of corticosteroids has also been considered. There has been an emerging interest in moisturizer containing non-steroidal anti-inflammatory agents such as herbal extracts, vitamins, mineral and lipids. The in vitro and the in vivo studies of each agent were reviewed. The clinical study on the efficacy of moisturizers containing these agents were also demonstrated including the author's studies and clinicalexperience. These moisturizers might be considered as an alternative treatment in acute flare of mild to moderate atopic dermatitis.
基金supported by a Project Funded by the Priority Academic Program Development of Jiangsu Higher Education Institutions
文摘Severe bleeding is a common problem and a main cause of death in a medical setting,including surgery,trauma,congenital and acquired abnormalities of hemostasis,fulminant hepatic failure,and gastrointestinal bleeding.It has been estimated that rxcessive blood loss may contribute to approximately 30% of trauma-related deaths.Bleeding in critical locations,especially intracerebral hemorrhage,pose also a major clinical challenge.Severe bleeding often needs blood transfusion.In many patients with abnormalities of hemostasis,bleeding can be effectively corrected by replacing the defective components of the hemostatic system,of which the most widely used are factor Ⅷ concentrations and recombinant factor Ⅷ products for hemophilia A treatment,prothrombin complex concentrates and recombinant factor Ⅸ for hemophilia B treatment,and fibrinogen or cryoprecipitate for afibrinogenemia.On the other hand,all the cases of excessive bleeding require pharmacologic strategies of hemostatic agents to minimize blood loss.
基金the National Natural Science Foundation of China,No.39660021
文摘AIM To investigate the effect of Boschniakiarossica（BR）extract on expression of GST-P,p53 and p21<sup>ras</sup>proteins in early stage of chemicalhepatocarcinogenesis in rats and its anti-inflammatory activities.METHODS The expression of tumor marker-placental form glutathione S-transferase（GST-P）,p53 and p21<sup>ras</sup>proteins were investigated byimmunohistochemical techniques and ABCmethod.Anti-inflammatory activities of BR werestudied by xylene and croton oil-induced mouseear edema,carrageenin,histamine and hotscald-induced rat pow edema,adjuvant-inducedrat arthritis and cotton pellet-induced mousegranuloma formation methods.RESULTS The 500 mg/kg of BR-H<sub>2</sub>O extractfractionated from BR-Methanol extract hadinhibitory effect on the formation of DEN-inducedGST-P-positive foci in rat liver（GST-P stainingwas 78% positive in DEN+AAF group vs 20%positive in DEN+AAF+BR group,P【0.05）andthe expression of mutant p53 and p21<sup>ras</sup>proteinwas lower than that of hepatic preneoplasticlesions（33% and 22% positive respectively inDEN+AAF group vs negative in DEN+AAF+BRgroup）.Both CH<sub>2</sub>Cl<sub>2</sub> and H<sub>2</sub>O extracts from BRhad anti-inflamatory effect in xylene and crotonoil-induced mouse ear edema（inhibitory rateswere 26%-29% and 35%-59%,respectively）. BR-H<sub>2</sub>O extract exhibited inhibitory effect incarrageenin,histamine and hot scald-inducedhind paw edema and adjuvant-induced arthritis inrats and cotton pellet-induced granulomaformation in mice.CONCLUSION BR extract exhibited inhibitory effect on formation of preneoplastic hepatic foci in early stage of rat chemical hepato-carcinogenesis. Both CH<sub>2</sub>CI<sub>2</sub> and H<sub>2</sub>O extracts from BR exerted anti-inflammatory effect in rats and mice.
文摘Directional migration of leukocytes is indispensable to innate immunity for host defense. However, recruitment of leukocytes to a site of tissue injury also constitutes a leading cause for inflammatory responses. Mechanistically, it involves a cascade of cellular events precisely regulated by temporal and spatial presentation of a repertoire of molecules in the migrating leukocytes and their surroundings (microenvironments). Here I will summarize the emerging evidence that has shed lights on the underlying molecular mechanism for directional migration of leukocytes, which has guided the therapeutical development for innovative anti-inflammatory medicines.
基金supported by the funding“Innovation Project of Shandong Province Agricultural Application Technology”(2130106)“Key Technology Research and Development Program of Shandong”(2019GNC106004).
文摘This novel study identifi es the effective anti-inflammatory phenolic compounds in dandelion and provides mechanistic insights into their interactions with receptor proteins(toll-like receptor 4,TLR4;co-receptor myeloid differentiation protein-2,MD-2)using UHPLC-ESI-MS/MS,lipopolysaccharide(LPS)-stimulated THP-1 cell line,fluorescence quenching and anisotropy,molecular docking(single ligand and multi-ligand docking)and molecular dynamics simulation.A 50%aqueous methanol extract had a greater anti-inflammatory effect and higher chicoric acid content,compared with the 100%water and 100%methanol extracts.Chicoric acid,chlorogenic acid,methylophiopogonone A,caffeic acid,gallic acid monohydrate and 4’-O-demethylbroussonin A had relatively high binding energies and contents in all extracts.Chicoric acid competed with chlorogenic acid,4’-O-demethylbroussonin A and quercetin for MD-2.Among dandelion’s phenolics,chicoric acid most effectively hindered TLR4-MD-2 complex formation,with a quenching constant of 0.62×10^(6) L/mol for MD-2 or TLR4 at 320 K,and binding energies of-6.87 and-5.97 kcal/mol,respectively,for MD-2 and TLR4.
文摘Background: Postoperative hemorrhage remains an uncommon but potentially life-threatening complication of thyroid surgery. The aim of this case-controlled study was to compare the effectiveness of PerClot® hemostatic agent with hemostasis by conventional technique (HCT) in thyroid surgery. Methods: The thyroid resection was performed from November 2009 to February 2010. Exclusion criteria were applied. There were 30 patients in the HCT group and 30 patients in the PerClot® group. The outcome parameters were postoperative bleeding, the drainage volume 24 hours postoperatively and adverse events according to PerClot®. Results: There was no post-operative hemorrhage in both groups. We found no significant difference between the control andPerClot® group with regard to total drainage volume after 24 h (51 ml ± 36.9 control group/53 ml ± 39.5 PerClot® group (p = 0.79)). There were no adverse events in the PerClot® group. Conclusions: Routine use of PerClot® hemostatic agent has no advantage over conventional hemostasis technique (HCT) in thyroid surgery. In addition, PerClot®?is safe and well tolerated.
文摘Non-variceal upper gastrointestinal(GI)bleeding is a significant cause of morbidity and mortality.Traditionally,through-the-scope(TTS)clips,thermal therapy,and injection therapies are used to treat GI bleeding.In this review,we provide an overview of novel endoscopic treatments that can be used to achieve hemostasis.Specifically,we discuss the efficacy and applicability of over-thescope clips,hemostatic agents,TTS doppler ultrasound,and endoscopic ultrasound,each of which offer an effective method of reducing rates of GI rebleeding.
基金We are very grateful to Dr.Florence Armstrong for her scientific advice and for participating in supervision of A-C.P.’s PhD research.We also express our gratitude to Dr.C´eline Revenu for her help in writing the article.We thank Dr.Claude Boucheix for his scientific advice and for proofreading of the paper.We are grateful to the UMS-44(ex UMS-33)for providing access to its many platforms,and especially to Denis Clay,who runs the Cytometry platform,as well as the whole team at the animal house.We warmly thank Aurore Devocelle,Antonietta Messina,Nassima Benzoubir,and Marwa Hussein for their help with experiments performed to help answer the reviewers’questions.Finally,we would like to thank the Direction G´en´erale de l’Armement(DGA)which partially financed A-C.P.’s PhD in the context of a CIFRE-D´efense thesis(n◦10/2014/DGA)in particular Dr.Emmanuelle Guillot-Combe,who is responsible for the follow-up of the PhD students.
文摘To control capillary bleeding, surgeons may use absorbable hemostatic agents, such as Surgicel® and TachoSil®. Due to their slow resorption, their persistence in situ can have a negative impact on tissue repair in the resected organ. To avoid complications and obtain a hemostatic agent that promotes tissue repair, a zinc-supplemented calcium alginate compress was developed: HEMO-IONIC®. This compress is non-absorbable and is therefore removed once hemostasis has been achieved. After demonstrating the hemostatic efficacy and stability of the blood clot obtained with HEMO-IONIC, the impact of Surgicel, TachoSil, and HEMO-IONIC on cell activation and tissue repair were compared (i) in vitro on endothelial cells, which are essential to tissue repair, and (ii) in vivo in a mouse skin excision model. In vitro, only HEMO-IONIC maintained the phenotypic and functional properties of endothelial cells and induced their migration. In comparison, Surgicel was found to be highly cytotoxic, and TachoSil inhibited endothelial cell migration. In vivo, only HEMO-IONIC increased angiogenesis, the recruitment of cells essential to tissue repair (macrophages, fibroblasts, and epithelial cells), and accelerated maturation of the extracellular matrix. These results demonstrate that a zinc-supplemented calcium alginate, HEMO-IONIC, applied for 10 min at the end of surgery and then removed has a long-term positive effect on all phases of tissue repair.
