Background: Recombinant human soluble thrombomodulin (rhTM) was approved for the treatment of disseminated intravascular coagulation in Japan, and rhTM has anti-inflammatory effects. Disordered coagulation is a part o...Background: Recombinant human soluble thrombomodulin (rhTM) was approved for the treatment of disseminated intravascular coagulation in Japan, and rhTM has anti-inflammatory effects. Disordered coagulation is a part of the acute respiratory distress syndrome (ARDS) pathophysiology and thus we hypothesize that anticoagulant therapy may help. This preliminary study was to observe the safety of rhTM administration and the improvement on biomarker levels after the therapy for ARDS-patients. Objectives: Case series of ARDS-patients. Methods: Seventeen ARDS-patients that required ventilatory management were treated with rhTM and clinical and laboratory data were collected including platelets, thrombin-antithrombin complex (TAT), fibrinogen degradation products, oxygen saturation/the fraction of inspired oxygen (SpO2/FIO2), and high-mobility group-1 (HMG-1). The administration of rhTM was started during 6 days at a bolus dose of 0.06 mg/kg/day immediately after the diagnosis of ARDS. Results: Eleven of the 17 ARDS-patients were alive at 28 days after the beginning of the administration of rhTM. The serial pattern of the SpO2/FIO2 showed remarkable differences between the survivors and nonsurvivors from day 5 to day 7. The TAT in the survivors significantly decreased after treatment, and there were significantly lower levels in the TAT on day 7 in comparison to that of the nonsurvivors. The serial changes of HMG-1 showed increased levels in the nonsurvivors until day 5 after the administration of rhTM. Conclusions: Additional rhTM administration can safely improve the parameters in survival ARDS-patients, as demonstrated by significant improvements in the SpO2/FIO2, HMG-1 and TAT.展开更多
Recently, mixed phenotype acute leukemia (MPAL) with t (9;22) (q34;q11.2);bcr-abl1 was described as one kind of acute leukemia of ambiguous lineage in the 2008 World Health Organization Classification of Tumors of Hem...Recently, mixed phenotype acute leukemia (MPAL) with t (9;22) (q34;q11.2);bcr-abl1 was described as one kind of acute leukemia of ambiguous lineage in the 2008 World Health Organization Classification of Tumors of Hematopoietic and Lymphoid Tissues. However, treatment strategy remains difficult for this uncommon MPAL. In addition, this type of MPAL is at high risk of tumor lysis syndrome (TLS) because of high chemo-sensitivity. Here, we report a MPAL with t (9;22) (q34;q11.2);bcr-abl1 case that suffered from life-threatening cerebral bleeding associated with disseminated intravascular coagulation (DIC) with TLS after bcr-abl positive acute lymphoblastic leukemia (ALL) type induction therapy who was successfully treated with recombinant human thrombomodulin (rhTM). This case reached complete remission without additive cerebral bleeding. In conclusion, bcr-abl positive ALL type induction therapy was effective for MPAL with t (9;22) (q34;q11.2);bcr-abl1 and rhTM was effective against DIC with TLS.展开更多
Objective: To explore the effect of Xuefu Zhuyu Decoction (XZD) on molecular expression of platelets glycoprotein Ⅱb/Ⅲa complex (GP Ⅱb/Ⅲa) and thrombomodulin (TM) of human umbilical vein endothelial cells.Methods:...Objective: To explore the effect of Xuefu Zhuyu Decoction (XZD) on molecular expression of platelets glycoprotein Ⅱb/Ⅲa complex (GP Ⅱb/Ⅲa) and thrombomodulin (TM) of human umbilical vein endothelial cells.Methods: Platelets and human umbilical vein endothelial cells were incubated with XZD of different concentration. GPⅡb/Ⅲa and TM were evaluated by radioimmunoassay.Results: XZD in 40 mg/ml and 80 mg/ml could obviously inhibit the adenosine diphosphate induced GPⅡb/Ⅲa complex expression, the molecular number being 52900±8445 and 52095±6345 respectively, and there was significant difference as comparing with that in the control group (P<0.05, P<0.01). But XZD didn't show any influence on the molecular expression of TM in human umbilical vein endothelial cells.Conclusion: XZD could inhibit the adenosine diphosphate induced activation of platete through blocking the exposure of GPⅡb/Ⅲa complex.展开更多
文摘Background: Recombinant human soluble thrombomodulin (rhTM) was approved for the treatment of disseminated intravascular coagulation in Japan, and rhTM has anti-inflammatory effects. Disordered coagulation is a part of the acute respiratory distress syndrome (ARDS) pathophysiology and thus we hypothesize that anticoagulant therapy may help. This preliminary study was to observe the safety of rhTM administration and the improvement on biomarker levels after the therapy for ARDS-patients. Objectives: Case series of ARDS-patients. Methods: Seventeen ARDS-patients that required ventilatory management were treated with rhTM and clinical and laboratory data were collected including platelets, thrombin-antithrombin complex (TAT), fibrinogen degradation products, oxygen saturation/the fraction of inspired oxygen (SpO2/FIO2), and high-mobility group-1 (HMG-1). The administration of rhTM was started during 6 days at a bolus dose of 0.06 mg/kg/day immediately after the diagnosis of ARDS. Results: Eleven of the 17 ARDS-patients were alive at 28 days after the beginning of the administration of rhTM. The serial pattern of the SpO2/FIO2 showed remarkable differences between the survivors and nonsurvivors from day 5 to day 7. The TAT in the survivors significantly decreased after treatment, and there were significantly lower levels in the TAT on day 7 in comparison to that of the nonsurvivors. The serial changes of HMG-1 showed increased levels in the nonsurvivors until day 5 after the administration of rhTM. Conclusions: Additional rhTM administration can safely improve the parameters in survival ARDS-patients, as demonstrated by significant improvements in the SpO2/FIO2, HMG-1 and TAT.
文摘Recently, mixed phenotype acute leukemia (MPAL) with t (9;22) (q34;q11.2);bcr-abl1 was described as one kind of acute leukemia of ambiguous lineage in the 2008 World Health Organization Classification of Tumors of Hematopoietic and Lymphoid Tissues. However, treatment strategy remains difficult for this uncommon MPAL. In addition, this type of MPAL is at high risk of tumor lysis syndrome (TLS) because of high chemo-sensitivity. Here, we report a MPAL with t (9;22) (q34;q11.2);bcr-abl1 case that suffered from life-threatening cerebral bleeding associated with disseminated intravascular coagulation (DIC) with TLS after bcr-abl positive acute lymphoblastic leukemia (ALL) type induction therapy who was successfully treated with recombinant human thrombomodulin (rhTM). This case reached complete remission without additive cerebral bleeding. In conclusion, bcr-abl positive ALL type induction therapy was effective for MPAL with t (9;22) (q34;q11.2);bcr-abl1 and rhTM was effective against DIC with TLS.
文摘Objective: To explore the effect of Xuefu Zhuyu Decoction (XZD) on molecular expression of platelets glycoprotein Ⅱb/Ⅲa complex (GP Ⅱb/Ⅲa) and thrombomodulin (TM) of human umbilical vein endothelial cells.Methods: Platelets and human umbilical vein endothelial cells were incubated with XZD of different concentration. GPⅡb/Ⅲa and TM were evaluated by radioimmunoassay.Results: XZD in 40 mg/ml and 80 mg/ml could obviously inhibit the adenosine diphosphate induced GPⅡb/Ⅲa complex expression, the molecular number being 52900±8445 and 52095±6345 respectively, and there was significant difference as comparing with that in the control group (P<0.05, P<0.01). But XZD didn't show any influence on the molecular expression of TM in human umbilical vein endothelial cells.Conclusion: XZD could inhibit the adenosine diphosphate induced activation of platete through blocking the exposure of GPⅡb/Ⅲa complex.
