Risk Factors for Mortality in Critically Ill Patients with Coagulation Abnormalities:A Retrospective Cohort Study

Objective Coagulation abnormalities are common and prognostically significant in intensive care units(ICUs)and are associated with increased mortality.This study aimed to explore the association between the levels of coagulation markers and the risk of mortality among ICU patients with coagulation abnormalities.Methods This retrospective study investigated patients with coagulation abnormalities in the ICU between January 2021 and December 2022.The initial point for detecting hemostatic biomarkers due to clinical assessment of coagulation abnormalities was designated day 0.Patients were followed up for 28 days,and multivariate logistic regression analysis was utilized to identify risk factors for mortality.Results Of the 451 patients analyzed,115 died,and 336 were alive at the end of the 28-day period.Multivariate analysis revealed that elevated thrombin-antithrombin complex(TAT),tissue plasminogen activator inhibitor complex(tPAIC),prolonged prothrombin time,and thrombocytopenia were independent risk factors for mortality.For nonovert disseminated intravascular coagulation(DIC)patients,older age and thrombocytopenia were associated with increased risks of mortality,whereas elevated levels of plasminα2-plasmin inhibitor complex(PIC)were found to be independent predictors of survival.In patients with overt DIC,elevated levels of tPAIC were independently associated with increased risks of mortality.Nevertheless,thrombocytopenia was independently associated with increased risks of mortality in patients with pre-DIC.Conclusion Coagulation markers such as the TAT,tPAIC,PIC,and platelet count were significantly associated with mortality,underscoring the importance of maintaining a balance between coagulation and fibrinolysis.These findings highlight the potential for targeted therapeutic interventions based on specific coagulation markers to improve patient outcomes.

Comparison between sepsis-induced coagulopathy and sepsis-associated coagulopathy criteria in identifying sepsis-associated disseminated intravascular coagulation

BACKGROUND:Disseminated intravascular coagulation(DIC)is associated with increased mortality in sepsis patients.In this study,we aimed to assess the clinical ability of sepsis-induced coagulopathy(SIC)and sepsis-associated coagulopathy(SAC)criteria in identifying overt-DIC and preDIC status in sepsis patients.METHODS:Data from 419 sepsis patients were retrospectively collected from July 2018 to December 2022.The performances of the SIC and SAC were assessed to identify overt-DIC on days 1,3,7,or 14.The SIC status or SIC score on day 1,the SAC status or SAC score on day 1,and the sum of the SIC or SAC scores on days 1 and 3 were compared in terms of their ability to identify pre-DIC.The SIC or SAC status on day 1 was evaluated as a pre-DIC indicator for anticoagulant initiation.RESULTS:On day 1,the incidences of coagulopathy according to overt-DIC,SIC and SAC criteria were 11.7%,22.0%and 31.5%,respectively.The specificity of SIC for identifying overt-DIC was significantly higher than that of the SAC criteria from day 1 to day 14(P<0.05).On day 1,the SIC score with a cut-off value>3 had a significantly higher sensitivity(72.00%)and area under the curve(AUC)(0.69)in identifying pre-DIC than did the SIC or SAC status(sensitivity:SIC status 44.00%,SAC status 52.00%;AUC:SIC status 0.62,SAC status 0.61).The sum of the SIC scores on days 1 and 3 had a higher AUC value for identifying the pre-DIC state than that of SAC(0.79 vs.0.69,P<0.001).Favorable effects of anticoagulant therapy were observed in SIC(adjusted hazard ratio[HR]=0.216,95%confidence interval[95%CI]:0.060–0.783,P=0.018)and SAC(adjusted HR=0.146,95%CI:0.041–0.513,P=0.003).CONCLUSION:The SIC and SAC seem to be valuable for predicting overt-DIC.The sum of SIC scores on days 1 and 3 has the potential to help identify pre-DIC.

A Two-Stage Approach for Electric Vehicle Routing Problem with Time Windows and Heterogeneous Recharging Stations

An Electric Vehicle(EV)is an appropriate substitution for traditional transportation means for diminishing greenhouse gas emissions.However,decision-makers are beset by the limited driving range caused by the low battery capacity and the long recharging time.To resolve the former issue,several transportation companies increases the travel distance of the EV by establishing recharging stations in various locations.The proposed Electric Vehicle-Routing Problem with Time Windows(E-VRPTW)and recharging stations are constructed in this context;it augments the VRPTW by reinforcing battery capacity constraints.Meanwhile,super-recharging stations are gradually emerging in the surroundings.They can decrease the recharging time for an EV but consume more energy than regular stations.In this paper,we first extend the E-VRPRTW by adding the elements of super-recharging stations.We then apply a two-stage heuristic algorithm driven by a dynamic programming process to solve the new proposed problem to minimize the travel and total recharging costs.Subsequently,we compare the experimental results of this approach with other algorithms on several sets of benchmark instances.Furthermore,we analyze the impact of super-recharging stations on the total cost of the logistic plan.

Two-Stage Optimal Scheduling of Community Integrated Energy System

From the perspective of a community energy operator,a two-stage optimal scheduling model of a community integrated energy system is proposed by integrating information on controllable loads.The day-ahead scheduling analyzes whether various controllable loads participate in the optimization and investigates the impact of their responses on the operating economy of the community integrated energy system(IES)before and after;the intra-day scheduling proposes a two-stage rolling optimization model based on the day-ahead scheduling scheme,taking into account the fluctuation of wind turbine output and load within a short period of time and according to the different response rates of heat and cooling power,and solves the adjusted output of each controllable device.The simulation results show that the optimal scheduling of controllable loads effectively reduces the comprehensive operating costs of community IES;the two-stage optimal scheduling model can meet the energy demand of customers while effectively and timely suppressing the random fluctuations on both sides of the source and load during the intra-day stage,realizing the economic and smooth operation of IES.

Solar-assisted two-stage catalytic membrane reactor for coupling CO_(2) splitting with methane oxidation reaction

A two-stage catalytic membrane reactor(CMR)that couples CO_(2) splitting with methane oxidation reactions was constructed based on an oxygen-permeable perovskite asymmetric membrane.The asymmetric membrane comprises a dense SrFe_(0.9)Ta_(0.1)O_(3-σ)(SFT)separation layer and a porous Sr_(0.9)(Fe_(0.9)Ta_(0.1))_(0.9)Cu_(0.1)O_(3-σ)(SFTC)catalytic layer.In thefirst stage reactor,a CO_(2) splitting reaction(CDS:2CO_(2)→2CO+O_(2))occurs at the SFTC catalytic layer.Subsequently,the O_(2) product is selectively extracted through the SFT separation layer to the permeated side for the methane combustion reaction(MCR),which provides an extremely low oxygen partial pressure to enhance the oxygen extraction.In the second stage,a Sr_(0.9)(Fe_(0.9)Ta_(0.1))_(0.9)Ni_(0.1)O_(3-σ)(SFTN)catalyst is employed to reform the products derived from MCR.The two-stage CMR design results in a remarkable 35.4%CO_(2) conversion for CDS at 900℃.The two-stage CMR was extended to a hollowfiber configuration combining with solar irradiation.The solar-assisted two-stage CMR can operate stably for over 50 h with a high hydrogen yield of 18.1 mL min^(-1) cm^(-2).These results provide a novel strategy for reducing CO_(2) emissions,suggesting potential avenues for the design of the high-performance CMRs and catalysts based on perovskite oxides in the future.

Two-Stage Planning of Distributed Power Supply and Energy Storage Capacity Considering Hierarchical Partition Control of Distribution Network with Source-Load-Storage

Aiming at the consumption problems caused by the high proportion of renewable energy being connected to the distribution network,it also aims to improve the power supply reliability of the power system and reduce the operating costs of the power system.This paper proposes a two-stage planning method for distributed generation and energy storage systems that considers the hierarchical partitioning of source-storage-load.Firstly,an electrical distance structural index that comprehensively considers active power output and reactive power output is proposed to divide the distributed generation voltage regulation domain and determine the access location and number of distributed power sources.Secondly,a two-stage planning is carried out based on the zoning results.In the phase 1 distribution network-zoning optimization layer,the network loss is minimized so that the node voltage in the area does not exceed the limit,and the distributed generation configuration results are initially determined;in phase 2,the partition-node optimization layer is planned with the goal of economic optimization,and the distance-based improved ant lion algorithm is used to solve the problem to obtain the optimal distributed generation and energy storage systemconfiguration.Finally,the IEEE33 node systemwas used for simulation.The results showed that the voltage quality was significantly improved after optimization,and the overall revenue increased by about 20.6%,verifying the effectiveness of the two-stage planning.

Effects of Coagulation and Ozonation Pretreatments on Biochemical Treatment of Fluid Catalytic Cracking Wastewater

Fluid catalytic cracking (FCC) salty wastewaters, containing quaternary ammonium compounds (QACs), are very difficult to treat by biochemical process. Anoxic/oxic (A/O) biochemical system, based on nitrification and denitrification reactions, was used to assess their possible biodegradation. Because of the negative effects of high salt concentration (3%), heavy metals and toxic organic matter on microorganisms’ activities, some techniques consisting of dilution, coagulation and flocculation, and ozonation pretreatments, were gradually tested to evaluate chemical oxygen demand (COD), ammonia-nitrogen (ammonia-N) and total nitrogen (TN) removal rates. In this process of FCC wastewater, starting with university-domesticated sludge, the ammonia-N and TN removal rates were worst. However, when using domesticated SBR’s sludge and operating with five-fold daily diluted influent (thus reducing salt concentration), the ammonia-N removal reached about 57% while the TN removal rate was less than 37% meaning an amelioration of the nitrification process. However, by reducing the dilution factors, these results were inflected after some days of operation, with ammonia-N removal decreasing and TN barely removed meaning a poor nitrification. Even by reducing heavy metals concentration with coagulation/flocculation process, the results never changed. Thereafter, by using ozonation pre-treatment to degrade the detected organic matter of di-tert-butylphenol and certain isoparaffins, COD, ammonia-N and TN removal rates reached 92%, 62% and 61%, respectively. These results showed that the activities of the microorganisms were increased, thus indicating a net denitrification and nitrification reactions improvement.

Hybrid argon plasma coagulation for the treatment of Barrett’s esophagus:A prospective,multicenter study

BACKGROUND The incidence of Barrett’s esophagus(BE)in China is lower compared to the Western populations.Hence,studies conducted in the Chinese population has been limited.The current treatment options available for BE treatment includes argon plasma coagulation(APC),radiofrequency ablation and cryoablation,all with varying degrees of success.AIM To determine the efficacy and safety of HybridAPC in the treatment of BE.METHODS The study cohort consisted of patients with BE who underwent HybridAPC ablation treatment.These procedures were performed by seven endoscopists from different tertiary hospitals.The duration of the procedure,curative rate,complications and recurrent rate by 1-year follow-up were recorded.RESULTS Eighty individuals were enrolled for treatment from July 2017 to June 2020,comprising of 39 males and 41 females with a median age of 54 years(range,30 to 83 years).The technical success rate of HybridAPC was 100%and the overall curative rate was 98.15%.No severe complications occurred during the operation.BE cases were classified as short-segment BE and long-segment BE.Patients with short-segment BE were all considered cured without complications.Thirty-six patients completed the one-year follow-up without recurrence.Twenty-four percent had mild dysplasia which were all resolved with one post-procedural treatment.The mean duration of the procedure was 10.94±6.52 min.CONCLUSION Treatment of BE with HybridAPC was found to be a simple and quick procedure that is safe and effective during the short-term follow-up,especially in cases of short-segment BE.This technique could be considered as a feasible alternative ablation therapy for BE.

Influence of two-stage harvesting on the properties of cold-pressed rapeseed(Brassica napus L.)oils

Rapeseed(Brassica napus L.)harvesting method is critical since it significantly determines the seed yield,oil quality,and industrial efficiency.This study investigated the influences of harvesting methods on the quality of cold-pressed rapeseed oil of two varieties.Oil color,peroxide value(POV),tocopherol content,fatty acid composition,and polarity of total polyphenols(PTP)contents of two rapeseed varieties in Huanggang and Xiangyang were compared through artificially simulated combined harvesting and two-stage harvesting.Results showed significant differences in the quality of rapeseed oil between the two harvesting methods.The red value(R-value),POV,total tocopherol contents,linoleic and linolenic acid content,and PTP content of the pressed rapeseed oil prepared by the combined harvesting method were about 27.6,5.7,15.8,2.0,0.5,and 28.6%lower than those of the oil produced from the two-stage harvesting method,respectively.Xiangyang and Huayouza62 performed better in the two regions and two varieties,respectively.To sum up,the rapeseed oil obtained 41–44 days after final flowering of combined harvesting,35 days after final flowering,and six days of post-ripening of the two-stage harvesting had the best quality.

Coagulation abnormalities and their relationship with bleeding manifestations in patients with dengue-A single center observational study

Objective:To evaluate coagulation abnormalities and their relationship with bleeding manifestations among patients with dengue.Methods:This observational study was conducted on 292 adult dengue patients who were admitted to a tertiary care hospital of Western India from July 2021 to June 2022.Coagulation tests including prothrombin time(PT),international normalized ratio(INR),activated partial thromboplastin time(aPTT),fibrinogen,and D-dimer were performed.Patients were monitored for bleeding manifestations.Results:Coagulation abnormalities were reported in 42.8%of the patients.Overall,prolonged aPTT was the most common coagulation abnormality(40.8%),followed by low fibrinogen(38.7%),raised D-dimer(31.2%),raised INR(26.0%)and prolonged PT(19.2%).Bleeding manifestations were present in 19.9%patients.PT,INR,aPTT and D-dimer levels were significantly higher(P<0.01)and fibrinogen level was significantly lower(P<0.001)in patients with bleeding compared to patients without bleeding.Patients with bleeding had a significantly higher rate of all coagulation abnormalities than patients without bleeding(P<0.01).Conclusions:Patients with bleeding showed a significantly higher frequency of coagulation abnormalities compared to patients without bleeding.Patients with dengue should be assessed for coagulation abnormalities.

Tourism Route Recommendation Based on A Multi-Objective Evolutionary Algorithm Using Two-Stage Decomposition and Pareto Layering

Tourism route planning is widely applied in the smart tourism field.The Pareto-optimal front obtained by the traditional multi-objective evolutionary algorithm exhibits long tails,sharp peaks and disconnected regions problems,which leads to uneven distribution and weak diversity of optimization solutions of tourism routes.Inspired by these limitations,we propose a multi-objective evolutionary algorithm for tourism route recommendation(MOTRR)with two-stage and Pareto layering based on decomposition.The method decomposes the multiobjective problem into several subproblems,and improves the distribution of solutions through a two-stage method.The crowding degree mechanism between extreme and intermediate populations is used in the two-stage method.The neighborhood is determined according to the weight of the subproblem for crossover mutation.Finally,Pareto layering is used to improve the updating efficiency and population diversity of the solution.The two-stage method is combined with the Pareto layering structure,which not only maintains the distribution and diversity of the algorithm,but also avoids the same solutions.Compared with several classical benchmark algorithms,the experimental results demonstrate competitive advantages on five test functions,hypervolume(HV)and inverted generational distance(IGD)metrics.Using the experimental results of real scenic spot datasets from two famous tourism social networking sites with vast amounts of users and large-scale online comments in Beijing,our proposed algorithm shows better distribution.It proves that the tourism routes recommended by our proposed algorithm have better distribution and diversity,so that the recommended routes can better meet the personalized needs of tourists.

Multi-source coordinated stochastic restoration for SOP in distribution networks with a two-stage algorithm

After suffering from a grid blackout, distributed energy resources(DERs), such as local renewable energy and controllable distributed generators and energy storage can be used to restore loads enhancing the system’s resilience. In this study, a multi-source coordinated load restoration strategy was investigated for a distribution network with soft open points(SOPs). Here, the flexible regulation ability of the SOPs is fully utilized to improve the load restoration level while mitigating voltage deviations. Owing to the uncertainty, a scenario-based stochastic optimization approach was employed,and the load restoration problem was formulated as a mixed-integer nonlinear programming model. A computationally efficient solution algorithm was developed for the model using convex relaxation and linearization methods. The algorithm is organized into a two-stage structure, in which the energy storage system is dispatched in the first stage by solving a relaxed convex problem. In the second stage, an integer programming problem is calculated to acquire the outputs of both SOPs and power resources. A numerical test was conducted on both IEEE 33-bus and IEEE 123-bus systems to validate the effectiveness of the proposed strategy.

Two-stage revision in periprosthetic knee joint infections

Periprosthetic joint infection(PJI)following total knee arthroplasty is one of the most catastrophic and costly complications that carries significant patient wellness as well as economic burdens.The road to efficiently diagnosing and treating PJI is challenging,as there is still no gold standard method to reach the diagnosis as early as desired.There are also international controversies with respect to the best approach to manage PJI cases.In this review,we highlight recent advances in managing PJI following knee arthroplasty surgery and discuss in depth the two-stage revision method.

Investigating the Performance of the Coagulation Process When Using a Combination of Zinc Oxide Nanoparticles and Ferric Polysulfate

In this article, a new type of coagulant material has been investigated and the performance of the coagulation process using this type of coagulant was evaluated. This new type is a combination of zinc oxide nanoparticles and polyferric sulfate (ZnOPFS). The structure of zinc oxide nanoparticles was determined by spectroscopic, X-ray and electron microscopy methods, and based on this, it was determined that ZnOPFS is a complex and mixed compound that is mainly composed of zinc oxide nanoparticles and ferric sulfate. The effects of Zn/Fe (Zn/Fe) molar ratio and aging (time) on acidity and zeta potential were also evaluated using a specific method. The obtained results showed that in the simultaneous deposition process, zinc ions can prevent the formation of polyferric acid coagulation and subsequently improve the stability of ZnOPFS.

Virus Removal by Iron Coagulation Processes

Waterborne viruses account for 30% to 40% of infectious diarrhea, and some viruses could persevere for some months in nature and move up to 100 m in groundwater. Using filtration setups, coagulation could lessen virus charges as an efficient pre-treatment for reducing viruses. This work discusses the present-day studies on virus mitigation using coagulation in its three versions i.e., chemical coagulation (CC), enhanced coagulation, and electrocoagulation (EC), and debates the new results of virus demobilization. The complexity of viruses as bioparticles and the process of virus demobilization should be adopted, even if the contribution of permeability in virus sorption and aggregation needs to be clarified. The information about virion permeability has been evaluated by interpreting empirical electrophoretic mobility (EM). No practical measures of virion permeability exist, a clear link between permeability and virion composition and morphology has not been advanced, and the direct influence of inner virion structures on surface charge or sorption has yet to be conclusively demonstrated. CC setups utilizing zero-valent or ferrous iron could be killed by iron oxidation, possibly using EC and electrooxidation (EO) methods. The oxidants evolution in the iron oxidation method has depicted promising findings in demobilizing bacteriophage MS2, even if follow-up investigations employing an elution method are needed to secure that bacteriophage elimination is related to demobilization rather than sorption. As a perspective, we could be apt to anticipate virus conduct and determine new bacteriophage surrogates following subtle aspects such as protein structures or genome size and conformation. The present discussion’s advantages would extend far beyond an application in CC—from filtration setups to demobilization by nanoparticles to modeling virus fate and persistence in nature.

Perioperative coagulation activation after permanent pacemaker placement

BACKGROUND Bradyarrhythmias are typically treated with permanent pacemakers(PM). The elimination of bradyarrhythmia by PM implantation improves the patient’s quality of life and prognosis, but it can also result in a number of sequalae. It is still unclear how PM implantation affects the hemostasis system’s parameters and how such parameters relate to different consequences after PM placement.AIM To assess the blood coagulation factor activity in PM patients throughout the perioperative period.METHODS Patients treated in the Department of Surgical Therapy of Cardiac Arrhythmias and Pacing at the Ryazan State "Regional Clinical Cardiology Dispensary" from April 2020 to December 2021 were included in the study. Before surgery, 7 and 30 d after PM placement, peripheral venous blood samples were withdrawn to measure the level of blood coagulation factor Ⅰ(FⅠ) and the activity of blood coagulation factors Ⅱ(FⅡ), Ⅴ(FⅤ), Ⅶ(FⅦ), Ⅷ(FⅧ), ⅸ(Fⅸ), ⅹ(Fⅹ), Ⅺ(FⅪ), Ⅻ(FⅫ). We used an automatic coagulometer Sysmex CA 660(Sysmex Europe, Germany) and reagents from Siemens(Siemens Healthcare Diagnostics Products GmbH, Germany).RESULTS The study included 146 patients. The activity of factors FⅤ [147.7(102.1-247.55)% vs 103.85(60-161.6)% vs 81.8(67.15-130.65)%, P = 0.002], FⅧ [80.4(60.15-106.25)% vs 70.3(48.5-89.1)% vs 63.7(41.6-88.25)%, P = 0.039], Fⅸ [86.2(70.75-102.95)% vs 75.4(59.2-88.3)% vs 73.9(56.45-93.05)%, P = 0.014], Fⅹ [188.9(99.3-308.18)% vs 158.9(83.3-230)% vs 127.2(95.25-209.35)%, P = 0.022], FⅪ [82.6(63.9-103.6)% vs 69.75(53.8-97.6)% vs 67.3(54.25-98.05)%, P = 0.002], FⅫ [87.6(67.15-102.3)% vs 78.9(63.4-97.05)% vs 81.2(62.15-97.4)%, P < 0.001] decreased at 7 and 30 d after surgery;FⅡ activity [157.9(109.7-245.25)% vs 130(86.8-192.5)% vs 144.8(103.31-185.6)%, P = 0.021] decreased at 7 d and increased at 30 d postoperatively. There were no statistically significant changes in the FVII activity within 30 d after PM placement [182.2(85.1-344.8)% vs 157.2(99.1-259)% vs 108.9(74.9-219.8)%, P = 0.128]. Subgroup analysis revealed similar changes only in patients on anticoagulant therapy. FⅫ activity decreased in patients on antiplatelet therapy [82(65.8-101.9)% vs 79.9(63.3-97.1)% vs 89.7(75.7-102.5)%, P = 0.01] 7 d after surgery, returning to baseline values at 30 d postoperatively.CONCLUSION PM placement and anticoagulant therapy were associated with decreased activity of clotting factors FⅤ, FⅧ, Fⅸ, Fⅹ, FⅪ, FⅫ in the postoperative period. FⅧ activity did not decrease within 30 d after PM placement, which may indicate endothelial injury caused by lead placement.

A two-stage but time-saving reconstructive scheme to treat severe lower limb length discrepancy:Two case reports

Limb length discrepancy(LLD)is a common orthopedic condition that can result in significant functional impairment,pain,and cosmetic deformities.Current reconstructive techniques for severe LLD are primarily based on callus distraction,which is a time-consuming process that can lead to complications,such as significant infection,joint stiffness,and stress fractures.To reduce the therapeutic time and minimize the risk of complications,we investigated the use of vascularized bone flaps as a technical supplement to callus distraction in the reconstruction of short limbs.We present two cases of severe LLD in the upper and lower legs,in which a twostage reconstruction approach was used.In the first stage,external fixation was applied to the affected limb to correct the soft tissue length and convert the short deformity into a bone defect.In the second stage,the bone defect was reconstructed using bilateral(patient A)or unilateral(patient B)free vascularized fibula bone grafts.Both patients had complete survival of the fibular grafts without stress fractures,and bone consolidation took 8 months(patient A)and 4 months(patient B).Compared to the traditional callus distraction,the two-stage approach was found to be more time-saving and reliable.The entire reconstructive scheme required 18 and 4 months for patients A and B,respectively,whereas the traditional callus distraction required 41 and 17 months,respectively.These findings suggest that the use of vascularized bone flaps as a technical supplement for callus distraction may provide an effective and efficient alternative for the treatment of severe LLD.Further studies are needed to validate these results and assess the long-term outcomes of this approach.

A New Two-Stage Tunable Space-Time Adaptive Detector

In order to improve the rejection capability of mismatched interferer signals,a new two-stage detector is proposed under homogeneous scenarios with unknown covariance matrix,which is obtained by cascading the adaptive matched filter(AMF)detector and the enhanced RAO(EnRAO)detector.The new detector has constant false alarm performance,and the closed-form expression of probability of false alarm and probability of detection is derived.The performance of the new detector is assessed,and analyzed in comparison with other detectors.The results show that,the proposed detector can provide enhanced rejection capability in the case of mismatch,but the performance of the detector is slightly lost under the condition of matching.

Expression and Purification of Human Coagulation Factor X in Mammalian CHO-DG44 Cells

[Objectives]This study was conducted to obtain a Chinese hamster ovary cell line that stably expresses recombinant human coagulation factor X(rhFX),and to induce efficient expression of the target gene with different concentrations of methotrexate(MTX).[Methods]PCR was performed to obtain the rhFX gene,and a recombinant expression plasmid pOptiVEC-rhFX was constructed and subjected to double restriction endonuclease digestion and sequencing identification.CHO-DG44(DHFR-)cells were transfected by the liposome method,and the target protein was purified by affinity chromatography and detected by SDS-PAGE electrophoresis and Western blot.A cell line with efficient and stable expression of the target gene was obtained by increasing the concentration of MTX to select positive clones.[Results]PCR yielded a 1509 bp rhFX sequence,and the results of double digestion and sequencing showed that the constructed pOptiVEC-rhFX plasmid was correct.After transfection of cells,MTX significantly increased protein expression.When MTX reached 1.0μmol/L,the expression efficiency of the target protein was(9±0.27)μg/ml.The purity of the target protein purified by affinity chromatography was 93%,which could be used for subsequent experiments.The expression efficiency of rhFX in eukaryotic mammalian cells was improved by increasing MTX concentration,and an affinity chromatography purification process for the target protein was preliminarily established.[Conclusions]The results of this study provide data support for the expression and purification of rhFX,and will lay a solid foundation for the development of drugs related to rhFX.

Clinical association between coagulation indicators and bone metastasis in patients with gastric cancer

BACKGROUND Bones are one of the most common target organs for cancer metastasis.Early evaluation of bone metastasis(BM)status is clinically significant.Cancer patients often experience a hypercoagulable state.AIM To evaluate the correlation between coagulation indicators and the burden of BM in gastric cancer(GC).METHODS We conducted a single-center retrospective study and enrolled 454 patients.Clinical information including routine blood examination and coagulation markers were collected before any treatment.Patients were grouped according to the status of BM.Receiver operating characteristic curves were used to assess diagnostic performance and determine the optimal cutoff values of the above indicators.Cutoff values,sensitivity and specificity were based on the maximum Youden index.Univariate and multivariate logistic regression analyses were used to evaluate the relationships between biomarkers and BM.RESULTS Of the 454 enrolled patients,191 patients were diagnosed with BM.The receiver operating characteristic curve analysis suggested that prothrombin time(PT)Wang X et al.Coagulation indicators predict bone metastasis WJGO https://www.wjgnet.com 1254 July 15,2023 Volume 15 Issue 7[cutoff:13.25;sensitivity:0.651;specificity:0.709;area under receiver operating characteristic curve(AUC)=0.738],activated partial thromboplastin time(aPTT)(cutoff:35.15;sensitivity:0.640;specificity:0.640;AUC=0.678)and fibrin degradation products(FDP)(cutoff:2.75;sensitivity:0.668;specificity:0.801;AUC=0.768)act as novel predictors for BM.Based on multivariate logistic regression analysis,the results showed the independent correlation between PT[odds ratio(OR):3.16;95%confidence interval(CI):1.612-6.194;P=0.001],aPTT(OR:2.234;95%CI:1.157-4.313;P=0.017)and FDP(OR:3.17;95%CI:1.637-6.139;P=0.001)and BM in patients with GC.Moreover,age,carcinoembryonic antigen,erythrocyte and globulin were found to be significantly associated with BM.CONCLUSION Coagulation markers,namely PT,aPTT and FDP,might be potential predictors for screening BM in patients with GC.