Facile synthesis of composite polyferric magnesium-silicate-sulfate coagulant with enhanced performance in water and wastewater

The coagulation process is a widely applied technology in water and wastewater treatment.Novel composite polyferric mag-nesium-silicate-sulfate(PFMS)coagulants were synthesized using Na_(2)SiO_(3)·9H_(2)O,Fe_(2)(SO_(4))_(3),and MgSO_(4) as raw materials in this paper.The effects of aging time,Fe:Si:Mg,and OH:M molar ratios(M represents the metal ions)on the coagulation performance of the as-pre-pared PFMS were systematically investigated to obtain optimum coagulants.The results showed that PFMS coagulant exhibited good co-agulation properties in the treatment of simulated humic acid-kaolin surface water and reactive dye wastewater.When the molar ratio was controlled at Fe:Si:Mg=2:2:1 and OH:M=0.32,the obtained PFMS presented excellent stability and a high coagulation efficiency.The removal efficiency of ultraviolet UV254 was 99.81%,and the residual turbidity of the surface water reached 0.56 NTU at a dosage of 30 mg·L^(-1).After standing the coagulant for 120 d in the laboratory,the removal efficiency of UV254 and residual turbidity of the surface wa-ter were 88.12%and 0.68 NTU,respectively,which accord with the surface water treatment requirements.In addition,the coagulation performance in the treatment of reactive dye wastewater was greatly improved by combining the advantages of magnesium and iron salts.Compared with polyferric silicate-sulfate(PFS)and polymagnesium silicate-sulfate(PMS),the PFMS coagulant played a better decolor-ization role within the pH range of 7-13.

Application of Plant-Based Coagulants and Their Mechanisms in Water Treatment:A Review

This review describes the mechanisms of natural coagulants.It provides a good understanding of the two key processes of coagulation-flocculation:adsorption and charge neutralization,as well as adsorption and bridging.Various factors have influence the coagulation/flocculation process,including the effect of pH,coagulant dosage,coagulant type,temperature,initial turbidity,coagulation speed,flocculation speed,coagulation and flocculation time,settling time,colloidal particles,zeta potential,the effects of humic acids,and extraction density are explained.The bio-coagulants derived from plants are outlined.The impact of organic coagulants on water quality,focusing on their effects on the physicochemical parameters of water,heavy metals removal,and bacteriological water quality,is examined.The methods of extraction and purification of plant-based coagulants,highlighting techniques such as solvent extraction and ultrasonic extraction,are discussed.It also examines the parameters that influence these processes.The methods and principles of purification of coagulating agents,including dialysis,freeze-drying,ion exchange,electrophoresis,filtration,and centrifugation,are listed.Finally,it evaluates the sustainability of natural coagulants,focusing on the environmental,technical,and economic aspects of their use.At the end of this review,the readers should have a comprehensive understanding of the mechanisms,selection,extraction,purification,and sustainability of plant-based natural coagulants in water treatment.

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.

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.

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.

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.

Removal Effect of Coagulating Sedimentation Method on Polyethylene Microplastics in Water

Microplastic is a new kind of pollutant.It exists widely in the aquatic environment and seriously endangers the aquatic ecosystem.In this study,the coagulating sedimentation method was used to remove microplastics in water.Polyethylene(PE)was selected as the representative of microplastics,polyferric sulfate(PFS),polyaluminum chloride(PAC)and aluminum sulfate(AS)were used as coagulant,and polyacrylamide(PAM)was used as coagulant aid to study the effects of pH,coagulant concentration and sedimentation time on the removal of PE by single and composite coagulant.The results showed that when the dosage of PFS was 0.5 g/L and pH was 5.0,the removal rate could reach 82.14%,which was better than PAC and AS,indicating that PFS had better coagulation and sedimentation performance for PE;the composite coagulant of PFS+PAC+AS(1 g/L+0.2 g/L+0.2 g/L,pH was 5.0)had the highest removal rate of PE,reaching 96.06%;the removal rate of PE increased with the increase in sedimentation time,but considering that the longer sedimentation time has less contribution to the improvement of removal rate,it is recommended that 4 h is appropriate.

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.

凝固剂及加工条件对豆腐凝胶形成及品质影响研究进展

豆腐的本质是一种蛋白质凝胶体,是大豆蛋白(主要是7S和11S球蛋白)在热处理下发生变性使蛋白质分子结构展开,再通过盐离子、氢离子或酶等凝固剂作用下发生聚集,形成致密均匀且具有网状结构蛋白凝胶。豆腐凝胶的形成及豆腐品质受多种因素的影响。本文从凝固剂种类(盐类、酸类和酶类凝固剂)以及加工条件(加工原料、制浆方法、豆浆体系pH、热处理条件)角度出发,阐明凝固剂及加工条件对豆腐凝胶形成以及品质的影响研究进展。以期为豆腐制品的工业化生产提供理论指导,为豆腐食品的研究开发与品质调控提供科学依据。

In silico evidence of Remdesivir action in blood coagulation cascade modulation in COVID-19 treatment

BACKGROUND Coronavirus disease 2019(COVID-19)has demonstrated several clinical manifestations which include not only respiratory system issues but also liver,kidney,and other organ injuries.One of these abnormalities is coagulopathies,including thrombosis and disseminated intravascular coagulation.Because of this,the administration of low molecular weight heparin is required for patients that need to be hospitalized.In addition,Remdesivir is an antiviral that was used against Middle East Acute Respiratory Syndrome,Ebola,Acute Respiratory Syndrome,and other diseases,showing satisfactory results on recovery.Besides,there is evidence suggesting that this medication can provide a better prognosis for patients with COVID-19.AIM To investigate in silico the interaction between Remdesivir and clotting factors,pursuing a possibility of using it as medicine.METHODS In this in silico study,the 3D structures of angiotensin-converting enzyme 2(ACE2),Factor I(fibrinogen),Factor II(prothrombin),Factor III(thromboplastin),Factor V(proaccelerin),Factor VII(proconvertin),Factor VIII(antihemophilic factor A),Factor IX(antihemophilic factor B),Factor X(Stuart-Prower factor),and Factor XI(precursor of thromboplastin(these structures are technically called receptors)were selected from the Protein Data Bank.The structures of the antivirals Remdesivir and Osetalmivir(these structures are called ligands)were selected from the PubChem database,while the structure of Atazanavir was selected from the ZINC database.The software AutoDock Tools(ADT)was used to prepare the receptors for molecular docking.Ions,peptides,water molecules,and other ones were removed from each ligand,and then,hydrogen atoms were added to the structures.The grid box was delimited and calculated using the same software ADT.A physiological environment with pH 7.4 is needed to make the ligands interact with the receptors,and still the software Marvin sketch®(ChemAxon®)was used to forecast the protonation state.To perform molecular docking,ADT and Vina software was connected.Using PyMol®software and Discovery studio®software from BIOVIA,it was possible to analyze the amino acid residues from receptors that were involved in the interactions with the ligands.Ligand tortions,atoms that participated in the interactions,and the type,strength,and duration of the interactions were also analyzed using those software.RESULTS Molecular docking analysis showed that Remdesivir and ACE2 had an affinity energy of-8.8 kcal/moL,forming a complex with eight hydrogen bonds involving seven atoms of Remdesivir and five amino acid residues of ACE2.Remdesivir and prothrombin had an interaction with six hydrogen bonds involving atoms of the drug and five amino acid residues of the clotting factor.Similar to that,Remdesivir and thromboplastin presented interactions via seven hydrogen bonds involving five atoms of the drug and four residues of the clotting factor.While Remdesivir and Factor V established a complex with seven hydrogen bonds between six antiviral atoms and six amino acid residues from the factor,and Factor VII connected with the drug by four hydrogen bonds,which involved three atoms of the drug and three residues of amino acids of the factor.The complex between Remdesivir and Factor IX formed an interaction via 11 hydrophilic bonds with seven atoms of the drug and seven residues of the clotting factor,plus one electrostatic bond and three hydrophobic interactions.Factor X and Remdesivir had an affinity energy of-9.6 kcal/moL,and the complex presented 10 hydrogen bonds and 14 different hydrophobic interactions which involved nine atoms of the drug and 16 amino acid residues of the clotting factor.The interaction between Remdesivir and Factor XI formed five hydrogen bonds involving five amino acid residues of the clotting factor and five of the antiviral atoms.CONCLUSION Because of the in silico significant affinity,Remdesivir possibly could act in the severe acute respiratory syndrome coronavirus 2 infection blockade by interacting with ACE2 and concomitantly act in the modulation of the coagulation cascade preventing the hypercoagulable state.

紫癜性肾炎患儿纤维蛋白原与国际小儿肾脏病研究组病理分级及肾单位微观病变的关系研究

背景 临床中紫癜性肾炎(HSPN)患儿多存在纤维蛋白原(FIB)升高现象,但FIB与肾脏病变相关性的研究较少。目的 探讨HSPN患儿FIB与国际小儿肾脏病研究组(ISKDC)病理分级及肾单位部分微观病理变化的相关性,明确FIB能否评估HSPN患儿肾损伤轻重。方法 收集2017年12月—2022年12月在河南中医药大学第一附属医院儿科医院肾病病区住院同时行肾活检的HSPN患儿922例,汇总其做肾活检期间的临床信息、FIB及肾脏病理信息,并依据FIB水平将患儿分为A组(偏低)<2.38 g/L、B组(标准)2.38~4.98 g/L、C组(偏高)>4.98 g/L。采用Spearman秩相关分析探究FIB与ISKDC病理分级、肾小球系膜增生比例、新月体增生比例及肾小球急慢性病变情况的相关性;再通过受试者工作特征(ROC)曲线分析FIB对肾单位微观病理变化的预测情况。结果 922例已做肾活检的HSPN患儿中,FIB为(3.48±1.01)g/L。A组113例,FIB偏低率占12.26%;B组734例,FIB标准率占79.61%;C组75例,FIB偏高率占8.13%。ISKDC病理分级中Ⅱa型173例(18.76%)、Ⅱb型29例(3.15%)、Ⅲa型466例(50.54%)、Ⅲb型232例(25.16%)、Ⅳ型及以上22例(2.39%)(其中Ⅳa型2例,Ⅳb型18例,Ⅴ型2例)。Spearman秩相关分析结果显示,HSPN患儿FIB及FIB分组与肾脏病理ISKDC分级(r_(s)=0.146,P<0.001;r_(s)=0.129,P<0.001)呈正相关性。922例HSPN患儿中有911例(98.80%)存在系膜细胞增生,655例(71.04%)存在新月体增生。Spearman秩相关分析结果显示,FIB、FIB分组均与系膜细胞增生率呈弱正相关性(r_(s)=0.092,P=0.005;r_(s)=0.096,P=0.003),与新月体增生率呈正相关性(r_(s)=0.132,P<0.001;r_(s)=0.830,P=0.012)。922例HSPN患儿中肾小球急性病变763例(82.75%)、急慢性病变97例(10.52%)、慢性病变62例(6.73%)。HSPN患儿FIB与肾小球病变的急慢性情况呈正相关(r_(s)=0.145,P<0.001)。同时,HSPN患儿部分肾活检指标FIB比较,差异有统计学意义(P<0.05)。ROC曲线显示,FIB对肾小球硬化的灵敏度最高(灵敏度=0.900,特异度=0.303),FIB最佳截断值为2.835 mg/L;FIB对小管间质纤维化正向预测的ROC曲线下面积(AUC)=0.623,对小管细胞颗粒变性反向预测的AUC=0.641。结论 FIB可作为一项反映HSPN患儿肾脏病理变化轻重的实验室检查指标,能反映肾脏病理分级的轻重,与肾小球硬化、球囊粘连等肾单位微观指标关系密切,可协助临床诊断和治疗。

Coagulation and analgesic effects of aqueous extract of peanut shells on mice

Background:Peanut shells are a commonly discarded byproduct of peanut processing.However,recent studies have shown that they contain bioactive compounds that have potential health benefits.Specifically,water extract from peanut shells has been identified as a promising source of these compounds.Therefore,investigating the effects of water extract from peanut shells on coagulation and analgesia in mice could have significant implications for human health.Methods:(1)Analgesic experiments:The analgesic effect of the aqueous extract of peanut shells was observed by the hot plate method in mice.The aspirin group was used as a positive control group for analgesic experiments.(2)Coagulation experiment:the coagulation effect of the aqueous extract of peanut shells was observed by the capillary method and slide method.Yunnan Baiyao group was the positive control group of the coagulation test.Results:(1)The analgesic effect of peanut shell water extract on mice was prolonged with the increase in dose.The low,medium,and high dose groups of peanut shell could improve the pain domain of mice induced by the hot plate method in a certain period(P<0.05);with the increase of peanut shell water extract dose,liver weight coefficient increased(P<0.05).(2)Peanut shell water extract coagulated mice,and the high-dose group of peanut shells was the most significant.Within the scope of this study,the higher the concentration,the better the coagulation effect(P<0.05).Compared with distilled water group,the liver weight coefficients of the Yunnan Baiyao group,low,middle,and high dose groups of peanut shells were significantly increased(P<0.05).Conclusion:(1)The aqueous extract of peanut shells has a specific analgesic effect on mice.(2)The aqueous extract of peanut shells promotes coagulation,and the pro-coagulant effect is more significant with increasing dose and the liver weight coefficient increases.

甲状腺功能异常对凝血系统的影响及治疗药物相互作用研究进展

甲状腺功能异常患者的凝血指标可出现异常,存在潜在发生血栓或出血的风险。甲状腺功能亢进患者存在显著的血管内皮功能紊乱并引起血栓风险,但关于甲状腺功能减退对凝血功能的影响仍存在争议。甲状腺功能异常对凝血系统的潜在风险可能干扰抗凝药物治疗安全性,同时甲状腺疾病治疗药物与抗凝药物之间的相互作用也对患者的用药安全造成影响。该文基于既往研究文献分析甲状腺功能异常与凝血功能相关性,评估和探讨甲状腺功能异常对凝血系统的影响及相关治疗药物相互作用,以期为甲状腺功能紊乱合并凝血功能异常患者的诊治提供参考。

手术患者术后下肢深静脉血栓形成的术中预防方案分析

目的分析预防手术患者术后下肢深静脉血栓形成(LDVT)的术中应用方案。方法收集2022年3月至2023年2月于保定市第二中心医院收治的256例手术患者的临床资料,将2022年9月前未应用术中改良方案的患者作为常规组(n=119),将2022年9月开始应用术中改良方案的患者作为改良组(n=137)。比较两组患者的手术指标(手术时间、术中出血量、术后卧床时间、住院时间和配合度评分)、血流动力学指标(心率、平均动脉压)、手术前后股静脉血流指标(峰值血流速度、平均血流速度和血流量)、手术前后凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶时间(TT)和D-二聚体(D-D)]及术后LDVT的发生情况。结果改良组患者的手术时间、术后卧床时间、住院时间均明显短于常规组患者,术中出血量明显少于常规组患者,配合度评分明显高于常规组患者,差异均有统计学意义(P﹤0.01)。入室后,两组患者的心率、平均动脉压比较,差异均无统计学意义(P﹥0.05);术中10 min、术毕即刻,改良组患者的心率、平均动脉压均低于常规组患者,差异均有统计学意义(P﹤0.05)。术后,改良组患者股静脉的峰值血流速度、平均血流速度、血流量均高于常规组患者,差异均有统计学意义(P﹤0.01)。术后,改良组患者的PT、APTT、TT均长于常规组患者,D-D、FIB水平均低于常规组患者,LDVT的发生率低于常规组患者,差异有统计学意义(P﹤0.05)。结论手术室人员于术中应用改良方案能够改善患者术中血流动力学,提高手术配合度,降低术中出血量,从而减轻术后血液高凝状态,促进术后下肢静脉血液回流,降低术后LDVT的发生风险。

全自动凝血分析仪在子痫前期患者凝血功能检测中的临床应用

目的 探究全自动凝血仪在子痫前期患者凝血功能检测中的应用。方法 选取本院2019年3月-2022年3月期间的120例子痫前期患者设为研究组。轻度患者70例,重度患者50例,设为轻度组和重度组。同期选取正常妊娠孕妇120例设为对照组。采用CS-5100全自动凝血分析仪对活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(Fib)、凝血酶时间(TT)、D-二聚体(D-D)、纤维蛋白原降解产物(FDP)、抗凝血酶-Ⅲ(AT-Ⅲ)水平进行检测;计算不同浓度凝血七项不精密度CV值;测定APTT、PTTT日间不精密度;评判Fib、D-D、FDP、AT-Ⅲ的携带污染率,观察检测结果。结果 与对照组和轻度组相比,研究组和重度组的APTT、PT、TT、AT-Ⅲ水平降低,Fib、D-D、FDP水平升高(P <0.05);APTT、PT、Fib不同浓度(正常、中度、高度)水平的批内不精密度分别为0.475%~2.664%、0.632%~1.066%、1.995%~3.615%;单水平项目TT、D-D、FDP、AT-Ⅲ的CV批内分别为0.712%、4.241%、6.301%、5.441%;APTT、PT、TT日间不精密度较好,但Fib CV略大;Fib、D-D、FDP指标水平的判定标准均≤10%。结论 对子痫前期患者通过全自动凝血仪进行凝血七项检测,能够显著评估患者凝血功能状态,对于评估患者疾病严重程度具有关键作用,能够为临床治疗提供坚实依据,有利于后续治疗方案的制定。

超声引导下股神经、坐骨神经阻滞在跟骨骨折手术麻醉中的应用效果

目的:探究超声引导下股神经、坐骨神经阻滞在跟骨骨折手术麻醉中的应用效果。方法:选取2020年2月—2023年2月菏泽医学专科学校附属医院收治的跟骨骨折患者80例,以随机数字表法将其均分为对照组(椎管内麻醉)及观察组(超声引导下股神经、坐骨神经阻滞)各40例,对比两组麻醉效果;对比两组麻醉前(T_(0))、麻醉后5 min(T_(1))、麻醉后10 min(T_(2))、麻醉后15 min(T_(3))、麻醉后30min(T_(4))时刻的心率(HR)、平均动脉压(MAP)、血氧饱和度(SpO_(2));对比两组应激反应指标[肾上腺素(E)、皮质醇(Cor)]、凝血功能[凝血酶时间(TT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)]、不良反应发生率。结果:观察组麻醉效果Ⅰ级率高于对照组,差异有统计学意义(P<0.05)。两组T_(0)、T_(1)时刻HR、MAP、SpO_(2)水平比较差异均无统计学意义(P>0.05);对照组T_(2)、T_(3)、T_(4)时刻HR、MAP均高于T_(0)时刻,SpO_(2)均低于T_(0)时刻,差异均有统计学意义(P<0.05);观察组T_(2)、T_(3)、T_(4)时刻HR、MAP、SpO_(2)较T_(0)时刻差异均无统计学意义(P>0.05);观察组T_(2)、T_(3)、T_(4)时刻HR、MAP均低于对照组,SpO_(2)均高于对照组,差异均有统计学意义(P<0.05)。术前,两组E、Cor水平相较差异均无统计学意义(P>0.05);术后1 h两组E、Cor水平均升高,但观察组均低于对照组,差异均有统计学意义(P<0.05)。术前,两组TT、PT、APTT水平相较差异均无统计学意义(P>0.05);术后1 h,两组TT、PT、APTT水平均升高,且观察组均高于对照组,差异均有统计学意义(P<0.05)。观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论:对跟骨骨折患者实施超声引导下股神经、坐骨神经阻滞,麻醉效果显著,减轻应激反应,稳定术中血流动力学,改善血液高凝状态,降低并发症发生率。