Relevant detection indicator of prethrombotic state in patients with primary hypertension

BACKGROUND Hypertension is a common chronic disease that affects many people worldwide.Only a few reports related to the exploration of relevant indicators of the prethrombotic state in patients with primary hypertension(PH)in clinical settings were available.AIM To detect prethrombotic state-related indicators in patients with PH and analyze their differences in different patient populations to provide a laboratory basis for the clinical prevention and control of hypertensive thrombotic diseases.METHODS The general data of patients with PH who attended the Department of Cardiovascular Medicine,The First Affiliated Hospital of Jiangxi Medical College,from January 2022 to December 2022 were collected retrospectively.The patients were divided into three groups of 40 patients each according to the Grade of PH:Grade 1,Grade 2,and Grade 3 hypertension experimental group.The baseline data of 40 volunteers,who underwent physical examination in our hospital but were not diagnosed with PH during the same period,were included in the control group.The relevant indicators of prethrombotic state of the participants were compared,and mainly included inflammation-related indicators,hemorheology-related indicators,and coagulation function related indicators.The relationship between the aforementioned indicators and the progression of PH was analyzed.RESULTS No significant differences were observed in age,sex,diabetes mellitus,smoking history,drinking history,body mass index,New York Heart Association functional classification,or the course of hypertension among the four groups(P>0.05).The expressions of high-sensitivity C-reactive protein(hs-CRP),thrombomodulin(TM),hematocrit(Hct),erythrocyte sedimentation rate(ESR),P-selectin on platelet surface(CD62P),and fibrinogen(FIB)in the control group were<Grade 1 hypertension group<Grade 2 hypertension group<Grade 3 hypertension group,and the expressions of platelet(PLT),activated partial thromboplastin time(APTT),prothrombin(PT),and plasma thrombin time(TT)in the control group was>Grade 1 hypertension group>Grade 2 hypertension group>Grade 3 hypertension group,and the difference was statistically significant(P<0.05).The results of the multivariate logistic regression model showed that the expression of hs-CRP,TM,Hct,ESR,CD62P,PLT,APTT,PT,TT,and FIB in the included participants was related to the progression of PH.Among these,high expression of hs-CRP,TM,Hct,ESR,CD62P,APTT,PT,and TT,and low expression of PLT and FIB were risk factors for PH(OR>1,P<0.05).The results of the receiver operating characteristic curve analysis showed that the area under the curve of hs-CRP,TM,ESR,CD62P,APTT,PT,TT,and FIB for the prediction of PH were>0.80,and the prediction value was ideal.Linear correlation analysis with bivariate Spearman showed that hs-CRP,TM,Hct,ESR,CD62P,APTT,PT,and TT were positively correlated with each other(r>0,P<0.05);PLT and FIB were negatively correlated with hs-CRP,TM,Hct,ESR,CD62P,APTT,PT,and TT(r<0,P<0.05);and PLT and FIB were positively correlated(r>0,P<0.05).Linear correlation analysis using bivariate Spearman showed that hs-CRP,TM,Hct,ESR,CD62P,and FIB were positively correlated with each other(r>0,P<0.05),whereas PLT,APTT,PT,and TT were negatively correlated with hs-CRP,TM,Hct,ESR,CD62P,and FIB(r<0,P<0.05).There was a positive correlation between PLT,APTT,PT,and TT(r>0,P<0.05).CONCLUSION The relevant indicators of the prethrombotic state in patients with PH,such as hs-CRP,TM,Hct,ESR,CD62P,PLT,APTT,PT,TT,and FIB,showed differences.High expression of hs-CRP,TM,Hct,ESR,CD62P,and FIB,and low expression of PLT,APTT,PT,and TT are the keys to the occurrence,progression,and thrombotic state of PH.Based on the above serum indicators’expression in patients,targeted interventions can be administered to patients with abnormal expression levels to control the progression of their disease and reduce the risk of developing a prethrombotic state.

血塞通滴丸联合达格列净治疗2型糖尿病合并慢性心力衰竭的效果及对PTS的影响

目的探究血塞通滴丸联合达格列净治疗2型糖尿病(T2DM)合并慢性心力衰竭(CHF)的效果及其对血糖代谢、心功能、血栓前状态(PTS)的影响。方法选取2022年7月—2023年7月收治的90例T2DM合并CHF,据随机数字表法分为研究组和对照组各45例。2组均予强心、利尿等抗心力衰竭治疗,在此基础上,对照组予达格列净治疗,研究组予血塞通滴丸联合达格列净治疗,治疗3个月后对比2组治疗效果、不良反应。比较2组治疗前后血糖指标、心功能指标、PTS指标、心力衰竭症状(Lee氏心力衰竭评分)、生活质量[明尼苏达心力衰竭生活质量量表(MLHFQ)评分]、血清Nexilin、可溶性致癌抑制因子2(sST2)水平。结果研究组总有效率为88.89%(40/45)明显高于对照组的71.11%(32/45)(P<0.05),而不良反应发生率比较无明显差异(P>0.05)。与治疗前比较,2组治疗1个月、3个月后外周血空腹血糖、糖化血红蛋白、餐后2 h血糖水平均降低(P<0.05)。与对照组比较,研究组治疗1个月、3个月后左心室射血分数升高,左心室舒张末期内径、左心室收缩末期内径及血清氨基末端脑钠肽前体水平降低(P<0.01);与对照组比较,研究组治疗1个月、3个月后血清组织型纤溶酶原激活物、纤溶酶原激活物抑制物-1水平升高,纤维蛋白原、血栓素B2、Nexilin、sST2水平降低(P<0.01);与对照组比较,研究组治疗1个月、3个月后Lee氏心力衰竭评分、MLHFQ评分降低(P<0.01)。结论在抗心力衰竭治疗基础上血塞通滴丸联合达格列净治疗T2DM合并CHF效果确切,可改善心功能、血糖代谢、PTS,并可提高生活质量,缓解心力衰竭病情进展,具一定安全性,可能与调节Nexilin、sST2表达有关。

Experimental study of prethrombotic state in early severe myocardial contusion

Objective: To explore whether there existed prethrombotic state (PTS) in early severe myocardial contusion and its changes,so as to provide theoretical evidence for early clinical diagnosis and better treatment. Methods: The present study was carried out in the graded myocardial contusion model in rabbits,which had been previously established by the authors. Fourteen New Zealand rabbits were divided into 2 groups at random :Experimental group (severe myocardial contusion, n = 8) and control group (sham-impact, n = 6). The dynamic changes ofhemorrheology,tissue-type plasminogen activator (t-PA) activity,plasminogen activation inhibitor (PAI) activity,and pathologic changes were observed for 240 min after the impact or sham-impact. Results: ①In experimentalgroup,whole blood viscosity at low shear rate (ηb1) and erythrocyte aggregation index (EAI) increased significantly 30 min after contusion compared with those of pre-impact or control rabbits. There was a tendency of ηb1 andEAl descent 120 min after contusion,but they still remained high 240 min after contusion (P<0.05). The plasmat-PA activity showed a tendency to decrease,while the plasma PAI activity showed a tendency to increase 30 minafter contusion. The t-PA activity was significantly lower and PAI activity wad significantly higher 120 min aftercontusion than those in pre-impact or in control rabbits. Both t-PA and PAI activity showed more significantchanges 240 min after contusion. Pathologic changes were compatible with the changes of severe myocardial contusion. And the injury of coronary artery endothelial cells was found. ②In the control group,there were no significant changes in the aforementioned parameters. Conclusion: There is a PTS at the early stage of severe myocardialcontusion. PTS may be one of important factors in the development of severe myocardial contusion and its complications.

Meta-Analysis of Bushen Huoxue Method in the Treatment of Recurrent Spontaneous Abortion Due to Prethrombotic State

Objective:To evaluate the effectiveness and safety of Bushen Huoxue prescription in the treatment of recurrent spontaneous abortion(RSA)due to prethrombotic state(PTS).Methods:Databases such as CNKI,WanFang,VIP,CBM,PubMed,Embase,and Cochrane Library were searched for randomized controlled trials on Bushen Huoxue prescription in treating RSA due to PTS from inception to March 2021;meta-analysis was performed by RevMan Version 5.3.0 following quality evaluation.Results:Seven trials were included,with 496 patients;the meta-analysis indicated that Bushen Huoxue prescription has advantages on the improvement of total clinical effective rate[RR=1.22,95%CI(1.10,1.35),Z=3.80(P=0.0001)],embryo survival rate at pregnancy of 12 weeks[RR=1.25,95%CI(1.10,1.41),Z=3.53(P=0.0004)],D-dimer levels[SMD=-1.59,95%CI(-2.20,-0.97),Z=5.07(P<0.00001)],and fibrinogen levels[MD=-1.00,95%CI(-1.29,-0.70),Z=6.61(P<0.00001)],but the statistical heterogeneity was significant;in terms of incidence of adverse reactions,there was no statistical difference between Bushen Huoxue prescription and western medicine.Conclusion:Compared with western medicine alone,Bushen Huoxue prescription alone or in combination with western medicine showed significant advantages in improving the overall clinical efficiency,embryonic survival rate at 12 weeks of pregnancy,and reducing D-dimer values as well as fibrinogen levels,without any significant difference in the incidence of adverse effects;however,the number of included studies is small and there are drawbacks,such as small sample size and low quality;therefore,high-quality clinical studies with large sample size and rigorous trial designs are needed in the future to provide a reliable basis for the effectiveness and safety of TCM in reducing the incidence of RSA due to prethrombotic state.

Study of patients with OSAS in prethrombotic state

Objective:To investigate the molecular markers change of prethrombotic state in patients with obstructive sleep apnea syndrome (OSAS) and estimate the effects of nasal continuous positive airway pressure (nCPAP) therapy. Methods:To perform case-controlled study in 30 patients with OSAS and 30 healthy control group. The patients with OSAS were diagnosed by the polysomnography monitor system and treated by Auto-CPAP. Blood samples were taken and measured GMP-140, APTT, AT-Ⅲ,PAI and t-PA. Results: As compared with the normal controls, the level of GMP-140 which reflects platelet activation was increased in patients with OSAS[(29.67±8.68)% vs (3.07±1.74)%, P<0.05)],the levels of AT-Ⅲ which reflect anticoagulation function decreased [(74.47±5.91)% vs (98.60±3.57)%,P<0.05], and the level of t-PA which reflects the activity of the fibrinolysis system decreased [(4.11±1.36)μg vs (8.65±1.22)μg, P<0.05]. The level of PAI which reflects the inhibition of the fibrinolysis increased [(107.43±8.75)% vs (89.17±4.44)%,P<0.05]. Compared to nCPAP pretherapy, GMP-140 and PAI were decreased[(17.07±7.97)% vs (29.67±8.68)%, and (95.83±5.91)% vs (107.43±8.75)%,respectively, both P<0.05], AT-Ⅲ and t-PA increased [ (95.20±6.67)% vs (74.47±5.91)%, and(5.45±1.61)μg vs (4.11±1.36)μg, respectively, both P<0.05]. The nCPAP theraphy could significantly increase the minimum arterial oxygen saturation(SaO2%) during sleep[(90.37±2.31)% vs (68.3±7.48)%,P<0.05] and significantly deseased AI,AHI and systolic blood pressure(SBP).Conclusion:Prethrombotic state is present in patients with OSAS, nCPAP theraphy can correct nocturnal hypoxaemia, partly or totally reverse prethrombotic state of patients with OSAS, decrease OSAS-related thrombotic complications.

STUDY ON PRETHROMBOTIC STATE IN BURNED PATIENTS

Seventy-eight burned patients （53 males and 25 females） were classified into 4 groups （mild type: 14 cases, moderate type: 13 cases, severe type: 17 cases and super-severe type: 34 cases） in accordence with criteria established by the Chinese Society for burns. Twenty-two parameters related to platelet, coagulant and anticoagulant factors, fibrinolysis system and hemorrheology were determined at first 24 hours, on third and fifth post-burn days. The results were as follow: Fibrinogen antigen, von Willebrand factor antigen, plasminogen activitor inhibitor activity, thromboxane B2 and hematocrit and whole blood viscosity significantly increased, however antithrombin Ⅲ, protein C antigen, free protein S and 6-keto-prostaglandin F1α markedly decreased compared with normal control at first 24 hours post burn. In addition, fibrinogen antigen, von Willebrand factor antigen, plasminogen activitor inhibitor activity, thromboxane B2 and whole blood viscosity were persistently elevated, however, antithrombin Ⅲ, protein C, free protein S and 6-keto-prostaglandin F1α declined on third and fifth post burn days. These changes resulted in a prethrombotic state, being an important factor in genesis of microthrombosis on burn site and the cause of the deepening and aggravation of burn wound on the third and fifth days in burned patients.

Detection and significance of reproductive hormones, prethrombotic state markers and coagulation related factors in threatened abortion in early pregnancy

Objective:To investigate the changes and significance of reproductive hormones, prethrombotic state markers and coagulation related factors in threatened abortion in early pregnancy.Methods:Review the clinical data of threatened abortion in early pregnancy (include continuing pregnancy and miscarriages) and healthy pregnant women in the early pregnancy in our hospital, and the levels of reproductive hormones, prethrombotic state markers and coagulation related factors were compared between the three groups.Results: The results of single factor variance showed that the levels ofβ-HCG, progesterone, E2, PC, PLG, D-D, TAT, F1+2 and PAI-1 level were all statistically significant. Compared with the control group, the average levels ofβ-HCG, progesterone, E2 and PLG in the pregnancy maintenance group and the interrupted pregnancy group were significantly decreased, and the level of the interrupted pregnancy group was significantly lower than that of the pregnancy maintenance group. The levels of PC, D-D, TAT, F1+2 and PAI-1 in the pregnancy maintenance group and the interrupted pregnancy group were significantly higher than those in the control group, and the level of the interrupted pregnancy group was significantly higher than that of the pregnancy maintenance group. There was no significant difference in the level of AT III between the groups.Conclusion: There are significant abnormal levels of reproductive hormones, prethrombotic state markers and coagulation related factors in patients with threatened abortion in early pregnancy, the detection of its index level is of great value in predicting threatened abortion in the early stage.

低分子肝素钠联合保胎灵在复发性流产患者中的应用价值及对CRP与HO-1的影响

目的探讨低分子肝素钠联合保胎灵在复发性流产患者中的应用价值及对C-反应蛋白(CRP)与血红素加氧酶1(HO-1)的影响。方法选取2020年3月至2022年4月在我院接受治疗的108例复发性流产(RSA)患者作为研究对象,采用随机表法,将患者随机分为联合组(n=54)和传统组(n=54),传统组患者予以低分子肝素(LMWH);联合组患者加用保胎灵。比较两组患者激素水平、凝血功能、细胞相关因子水平、血清水平的变化、妊娠结局及其并发症的发生情况。结果治疗后,两组β-人绒毛膜促性腺激素(β-HCG)、雌二醇(E 2)和孕酮(P)、活化部分凝血酶原时间(APTT)、凝血酶原时间(PT)、转化生长因子-β(TGF-β)和白细胞介素-10(IL-10)、HO-1均升高,且联合组高于传统组(P<0.05);两组纤溶酶原激活抑制剂1(PAI-1)、白细胞介素-17(IL-17)、CRP均下降,且联合组低于传统组;联合组流产率显著低于传统组,活产率则明显高于传统组(P<0.05)。两组患者的足月产率比较差异无统计学意义(P>0.05)。联合组分娩周数显著长于传统组(P<0.05);两组患者妊娠并发症比较差异无统计学意义(P>0.05)。结论LMWH联合保胎灵能有效改善RSA患者妊娠期孕激素水平及凝血功能,提升保胎成功率改善妊娠结局,同时可调节细胞平衡,且对并发症无显著影响。

血栓前状态易感基因变异与复发性流产的相关性分析

目的探讨血栓前状态易感基因变异与复发性流产的相关性.方法选择2021-12至2023-12在解放军总医院第九医学中心就诊的复发性流产患者103例,并选择同期就诊的无自然流产史患者91例作为对照.分别对两组人群的血栓前状态易感基因变异进行检测,包括FVL基因1691位点、FⅡ基因20210位点、PAI-1基因675位点、MTHFR基因677位点和1298位点.结果两组FVL基因1691位点、FⅡ基因20210位点均未见杂合变异与纯合变异;两组间PAI-1基因675位点变异(χ^(2)=0.429,P=0.452)、MTHFR基因677位点(χ^(2)=1.346,P=0.510)和1298位点(χ^(2)=2.866,P=0.245)基因变异频率无统计学差异.单因素回归分析显示,PAI-1基因675位点(OR=1.245,95%CI:0.624~2.482,P=0.533),MTHFR基因677位点(OR=1.071,95%CI:0.571~2.009,P=0.830)和1298位点(OR=1.6324,95%CI:0.883~3.017,P=0.117)的基因变异与复发性流产无关.结论FVL基因、FⅡ基因、PAI-1基因及MTHFR基因变异与复发性流产无相关性,不建议此类患者常规进行遗传性血栓前状态检测.

神经重症患者下肢深静脉血栓危险因素分析及血栓前状态分子标志物的预测价值

目的:分析神经重症患者下肢深静脉血栓危险因素及血栓前状态分子标志物的预测价值。方法:回顾性分析2021年2月—2023年2月于德化县医院收治的80例患者的病历资料。以术后3 d是否形成血栓将患者分为血栓组(n=39)和非血栓组(n=41),比较两组病历资料及术前血栓前状态分子标志物水平[组织型纤溶酶原激活剂-纤溶酶原激活剂抑制剂-1复合物(t-PAIC)、凝血酶-抗凝血酶复合物(TAT)、纤溶酶-2α纤溶酶抑制物复合物(PIC)、血栓调节蛋白(TM)],采用单因素和多因素logistic回归分析神经重症患者下肢深静脉血栓形成的危险因素,通过绘制受试者工作特征(ROC)曲线分析t-PAIC、TAT、PIC、TM对神经重症患者下肢深静脉血栓的预测价值。结果:两组年龄、右下肢肌力、卧床时间、下肢深静脉穿刺、下肢制动、白细胞(WBC)、纤维蛋白原(FIB)、D-二聚体(D-D)、t-PAIC、TAT、PIC、TM、急性生理与慢性健康评分系统(APACHEⅡ)评分、Caprini评分比较,差异有统计学意义(P<0.05);多因素logistic分析结果显示,年龄≥65岁、下肢制动、D-D升高、t-PAIC、TAT、PIC、TM、Caprini评分是神经重症患者下肢深静脉血栓形成的独立危险因素(P<0.05);ROC曲线显示,TM、TAT、PIC、t-PAIC、联合预测ROC曲线下面积(AUC)分别为0.672、0.837、0.789、0.633、0.887。结论:血栓前t-PAIC、TAT、PIC、TM水平是影响神经重症患者下肢深静脉血栓的独立危险因素,联合检测能早期识别神经重症患者下肢深静脉血栓高危患者。

血清25(OH)D、Hcy及血栓前状态分子标志物与老年高血压病人认知功能障碍的关系

目的 探讨血清25-羟维生素D[25(OH)D]、同型半胱氨酸(Hcy)及血栓前状态分子标志物与老年高血压病人认知功能障碍的关系。方法 回顾性分析2021年3月至2023年3月于我院确诊的100例老年高血压病人的临床资料,根据是否合并认知功能障碍分为认知障碍组(26例)与非认知障碍组(74例)。收集病人一般资料,检测病人25(OH)D、Hcy、纤维蛋白原(Fbg)、纤溶酶原激活物抑制剂-1(PAI-1)、血管性血友病因子(vWF)、血小板α颗粒膜蛋白-140(GMP-140)水平。采用多因素Logistic回归分析老年高血压病人认知功能障碍的影响因素;使用ROC曲线分析各指标的诊断效能。结果 认知障碍组年龄、Hcy、Fbg、PAI-1、vWF、GMP-140水平显著高于非认知障碍组,25(OH)D水平显著低于非认知障碍组(P<0.01)。多因素Logistic回归分析显示,年龄、25(OH)D、Hcy、Fbg、PAI-1、vWF、GMP-140是老年高血压病人认知功能障碍的影响因素(P<0.05)。ROC曲线分析结果显示,25(OH)D、Hcy、Fbg、PAI-1、vWF、GMP-140预测老年高血压病人认知功能障碍的AUC分别为0.875、0.850、0.944、0.876、0.905、0.864。结论 25(OH)D、Hcy及Fbg、PAI-1、vWF、GMP-140水平与老年高血压病人认知功能障碍之间存在密切联系,是老年高血压病人认知功能障碍的风险预测因子。

小剂量阿司匹林联合维生素D预防性治疗高危PE效果及对孕妇凝血指标、血栓前状态的影响

目的:探讨小剂量阿司匹林(LDA)联合维生素D预防治疗高危子痫前期(PE)效果及对孕妇凝血指标、血栓前状态的影响。方法:选取2019年7月-2023年12月本院收治的PE高危孕妇135例,根据不同治疗分为对照组(n=45)、维生素D组(n=45)和联合组(n=45)。比较3组PE发生率、凝血指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)和D-二聚体(D-D)]、血栓前状态[凝血酶抗凝酶复合物(TAT)、纤溶酶-抗纤溶酶复合物(PIC)、血栓调节蛋白(TM)、组织型纤溶酶原激活抑制复合物(t-PAIC)]、子宮动脉血流动力学指标[阻力指数(RI)、搏动指数(PI)]、妊娠结局。结果:治疗后,联合组的PE发生率(11.1%)低于维生素D组(31.1%)和对照组(33.3%),APTT(30.34±2.00s)、PT(12.45±2.63s)均高于维生素D组(23.05±2.56s、9.46±2.07s)和对照组(22.98±3.18s、8.83±1.89s),FIB(3.24±1.03 g/L)、D-D(1.34±0.35 mg/L)低于维生素D组(4.57±1.47 g/L、2.53±0.42 mg/L)和对照组(5.25±1.36 g/L、3.38±0.60 mg/L),TAT(9.81±1.89 ng/ml)、PIC(1.35±0.46μg/ml)均低于维生素D组(13.42±2.16 ng/ml、1.66±0.58μg/ml)和对照组(14.15±2.30 ng/ml、1.72±0.53μg/ml),RI、PI均低于维生素D组和对照组,剖宫产率(33.3%)和低体重儿发生率(2.3%)低于维生素D组(55.6%、15.6%)和对照组(62.2%、17.8%)(P<0.05)。结论:采用LDA联合维生素D治疗PE高危孕妇可显著改善凝血功能、血栓前状态以及子宫动脉血流动力学,进而有效预防PE的发生并改善母婴结局。

基于密度泛函理论的S掺杂碳载体负载Pt催化剂对氧还原反应的影响

采用密度泛函方法对比研究了Pt/C催化剂中碳载体掺S前后对氧还原反应(ORR)的影响。从电荷分布、态密度及d带中心等性质出发,分析了金属-载体间相互作用,研究了ORR各物种在催化剂上的吸附并计算了ORR过电势。结果表明:S掺杂使得碳载体表面发生了电子转移,S上的电子转移到邻近的C原子上,负载Pt纳米颗粒后,Pt金属上的电子转移给了碳载体;Pt在S掺杂碳载体上的吸附更强,形成了Pt—C键和Pt—S键,Pt纳米颗粒的分散度和稳定性得到了提升;掺S使得催化剂d带中心下降,对ORR各中间体的吸附减弱,ORR过电势降低,表明掺S能提高催化剂的催化活性。

两种球囊在下肢动脉硬化闭塞症围术期中应用的效果比较

目的 探讨不同球囊在下肢动脉硬化闭塞症(ASO)治疗中的应用价值。方法 选取2020年6月至2022年6月行血管介入手术的106例ASO患者为研究对象,采用电脑随机法分为观察组和对照组,各53例。观察组术中采用药物涂层球囊,对照组术中采用普通球囊。比较2组临床疗效、手术前后氧化应激指标[超氧化物歧化酶(SOD)、硫氧还蛋白(TRX)、髓过氧化物酶(MPO)、丙二醛(MDA)]、血栓前状态指标[血栓前体蛋白(TpP)、血管假血友病因子(vWF)、总同型半胱氨酸(tHcy)]、踝肱指数(ABI)、靶动脉血管内径、Rutherford分级及并发症发生情况。结果 观察组总有效率(92.45%)明显高于对照组(77.36%)(P<0.05);术后3、7 d观察组SOD、TRX水平高于对照组,MPO、MDA水平低于对照组(P<0.05);术后3、7 d观察组TpP、vWF、tHcy水平低于对照组(P<0.05);术后3、7 d观察组ABI、靶动脉血管内径高于对照组(P<0.05);术后12个月观察组Rutherford分级分布优于对照组(P<0.05);2组并发症总发生率比较差异无统计学意义(P>0.05)。结论 两种球囊行血管介入手术治疗ASO患者,均具有较好的安全性,但药物涂层球囊能增强疗效,减轻氧化应激,改善血栓前状态,恢复患者血流,改善患者预后。

固肾安胎丸联合低分子肝素、小剂量阿司匹林对复发性流产患者血栓前状态及Th17/Treg的影响

目的探讨固肾安胎丸联合低分子肝素、小剂量阿司匹林对复发性流产患者血栓前状态及辅助性T细胞17(Th17)/调节性T细胞(Treg)的影响。方法择取2021年6月至2022年6月就诊的80例复发性流产患者为研究对象,随机将其分为对照组和观察组,各40例。对照组给予低分子肝素、小剂量阿司匹林治疗,观察组在对照组基础上加固肾安胎丸治疗。比较两组的治疗效果。结果治疗后,观察组的蛋白C(PC)、蛋白S(PS)及抗凝血酶Ⅲ(AT-Ⅲ)高于对照组,D-二聚体(D-D)水平低于对照组(P<0.05)。治疗后,观察组的Th17、Th17/Treg低于对照组,Treg高于对照组(P<0.05)。观察组的不良反应总发生率低于对照组(P<0.05)。结论固肾安胎丸联合低分子肝素、小剂量阿司匹林不仅能够调节复发性流产患者的血栓前状态,还能改善Th17/Treg指标,且不良反应较少。

Effects of Heat Clearing and Stasis Resolving Method on PTS,Inflammatory Factors and T-lymphocyte Subsets in Peripheral Blood of URM Patients with Suppressed Internal Heat

[Objectives]To explore the effects of heat clearing and stasis resolving method on prethrombotic state,inflammatory factors and T-lymphocyte subsets in peripheral blood of unexplained recurrent miscarriage(URM)patients with suppressed internal heat.[Methods]Thirty cases of URM patients with suppressed internal heat and 30 normal women were collected,and characteristics of changes in peripheral serum D-dimer(D-D),fibrin degradation product(FDP),fibrinogen(FIB),IL-6,IL-10 and TNF-α,CD,CD,CD,CD,CDlevels were detected.URM patients were treated with traditional Chinese medicine for clearing heat and resolving blood stasis for 3 menstrual cycles,and the changes of indicators before and after treatment were observed.[Results]Compared with normal women,the peripheral serum levels of D-D,IL-6,TNF-αand CDin URM patients with suppressed internal heat were increased(P<0.05),while the IL-10 lymphocyte level was significantly decreased(P<0.05);compared with that before treatment,the contents of D-D,IL-6,TNF-αand CDdecreased after 3 menstrual cycles(P<0.05),while the contents of IL-10 and CDT lymphocytes increased significantly(P<0.05).[Conclusions]The heat clearing heat and stasis resolving method can effectively improve the prethrombotic state of URM,and the action mechanism may be related to the regulation of immune and peripheral blood inflammatory factors.

Mechanism of Excited State Double Proton Transfer in 2-Amino-3-Methoxypyridine and Acetic Acid Complex

The excited-state double-proton transfer （ESDPT） mechanism of 2-amino-3-methoxypyridine and acetic acid com- plex is studied by the density functional theory （DFT） and time-dependent DFT with CAM-B3LYP functional. The complex is connected through two different types of inter-molecular hydrogen bonds. After photo-excitation, both hydrogen bonds get strengthened, which can facilitate the ESDPT reaction. The scanned potential energy curve along the proton transfer coordinate indicates that the ESDPT reaction proceeds in a stepwise pattern.

Steady-state kinetics and osillation phenomena for complete oxidation of benzene over Pt/Al_2O_3 catalyst

The steady-state kinetics for complete oxidation of benzene over has been investigated by the external recycling reactor. The kinetics equation was described by the L-H model of adsorption of benzene and oxygen with the inhibition of carbon dioxide. The parameters of the kinetics model were estimated by the method of orthogonal design. The heats of adsorption of benzene, oxygen and carbon dioxide were determined by the method of gas-adsorption chromatography. The details of oscillations of complete oxidation of benzene were investigated.

糖尿病视网膜病变患者血栓前状态相关标志物的变化及意义

目的 观察糖尿病视网膜病变(DR)患者全血血小板(PLT)计数及其参数平均血小板体积(MPV)、血小板体积分布宽度(PDW)、血浆纤维蛋白原(FIB)等止血与血栓相关指标水平的变化,寻找较特异、灵敏的指标辅助DR早期诊断。方法 选取2021年6月至2022年1月在首都医科大学附属北京同仁医院(以下简称为“我院”)收治的II型糖尿病(T2DM)患者159例,依据我院眼科荧光素眼底血管造影(FFA)检查结果分为3组:糖尿病无视网膜病变组(DM组)49例,非增生性糖尿病视网膜病变组(NPDR组)42例、增生性糖尿病视网膜病变组(PDR组)68例,另选取我院同期健康体检者59例作对照。测定全血PLT、MPV、PDW和血浆FIB、血栓调节蛋白(TM)、凝血酶-抗凝血酶复合物(TAT)、组织型纤溶酶原激活剂-纤溶酶原激活物抑制剂1复合物(tPAIC)、纤溶酶-α2抗纤溶酶复合物(PIC)等指标水平,比较各项指标在DR的水平变化。结果 (1)进行4组间比较,其中PDW、FIB、TM、PIC水平在4组间差异具有统计学意义(P<0.05),且均高于对照组,差异有统计学意义(P<0.05)。(2)2组间比较中,NPDR组和PDR组FIB、TM、PIC水平均分别高于DM组,差异有统计学意义(P<0.05),而PDW在DM组、NPDR组和PDR组的2组间比较差异无统计学意义(P>0.05)。(3)进行ROC曲线分析显示FIB、TM、PIC的灵敏度分别为71.2%、82.0%、52.3%,特异性分别为75.5%、55.1%、71.4%,对判断糖尿病是否合并视网膜病变具有一定诊断可能性。结论 在DR及其进展的患者,通过一些常规检验指标及血栓前状态标志物的检测或通过联合检测,对糖尿病视网膜病变的发生发展具有一定的辅助诊断意义。

痰湿壅盛型原发性高血压患者血栓前状态与心率变异性的相关分析

目的:探讨痰湿壅盛型原发性高血压患者血栓前状态(PTS)与心率变异性(HRV)的相关性。方法:收集广东省中医院符合纳入标准的痰湿壅盛型高血压患者159例,根据PTS各项结果分为观察组(79例)及对照组(80例)。对所有患者进行24 h动态心电图测量,比较两组患者一般情况、生化指标、PTS相关指标、HRV之间的差异,并采用Spearman相关性分析PTS各指标与HRV各指标之间的相关性。结果:两组患者性别、年龄、血压、合并糖尿病、合并冠心病、总胆固醇(TG)、高密度脂蛋白胆固醇(HDLC)、甘油三酯(TC)、低密度脂蛋白胆固醇(LDLC)比较,差异均无统计学意义(P>0.05)。观察组患者HRV各项指标均低于对照组,PTS各项指标均高于对照组,差异均有统计学意义(P<0.05)。Spearman相关分析结果显示:观察组凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)与24 h每5分钟节段平均窦性R-R间期的标准差(SDANN)、24 h窦性R-R间期标准差(SDNN)、相邻正常R-R间期差值的均方根(rMSSD)、相邻正常R-R间期的差值大于50 ms的心搏占正常心搏总数的百分比(pNN50)呈明显正相关,纤维蛋白原(FIB)、D-二聚体(D-D)、血小板计数(PLT)与SDANN、SDNN、rMSSD、pNN50呈明显负相关。结论:与单纯原发性高血压患者相比,原发性高血压合并PTS患者自主神经功能受损更加明显。原发性高血压患者HRV相关指标与PTS有明显相关性,定期监测原发性高血压患者PTS及HRV相关指标,对其病情评估、改善预后具有重要意义。