Glanzmann’s thrombasthenia(GT)is an inherited autosomal recessive bleeding disorder,resulting from mutations in the ITGA2B and ITGB3 genes,that lead to a defect in the platelet membrane integrinαIIbβ3.[1]As integri...Glanzmann’s thrombasthenia(GT)is an inherited autosomal recessive bleeding disorder,resulting from mutations in the ITGA2B and ITGB3 genes,that lead to a defect in the platelet membrane integrinαIIbβ3.[1]As integrinαIIbβ3 plays an important role in thrombus formation,the clinical manifestation of GT includes bleeding(mostly mucocutaneous)and purpura.For this reason,patients with GT are typically thought to be unlikely to suffer from thromboembolic incidents.Antithrombin is an anticoagulant that inhibits thrombin and is activated factor X and other serine proteases in the coagulation cascade.[2]Antithrombin deficiency is an autosomal dominant hereditary disease with an approximate prevalence of 1/500 in the overall population.[3]In contrast to the hemorrhagic tendency of GT,patients with antithrombin deficiency are at increased risk of thromboembolism,especially in the venous system.Herein,we describe a rare case of GT and antithrombin deficiency coexisting in a single patient.Rivaroxaban was used for the treatment of pulmonary embolism(PE)and deep vein thrombosis(DVT).展开更多
The purpose of the study is to evatuate the feasibility of pulsed dye laser(PDL)throm bolysis In vitro and the effect of PDL on vascular function and structure invivo.In vitro,fifty hum an throm biwere divided into la...The purpose of the study is to evatuate the feasibility of pulsed dye laser(PDL)throm bolysis In vitro and the effect of PDL on vascular function and structure invivo.In vitro,fifty hum an throm biwere divided into laser treated group(n=35),irritation group(n=11),and controgroup(n=4).In the laser treated group thethrom biwere irradiated by PDL with 300 pulses at 100m J/pulse.No irradiation wasgiven to the throm bi in the irritation group,while the catheter was put to and frointo the throm bi for there times,Neither irradintion nor irritation was given to thethrom bi in the controlgroup.Sixteen healthy dogs were studied in vivo.Under theguidance of the guide-w ire PDL catheter was put into the left coronary arteries(n=16)from which PDL was em itted for 1380±60 pulses at 100m J/pulse,whereasthe rightcoronary srteries(n=16)which did not receieve PDL em ission were servedas irritation group.Then the PDL were irradiated directly to the right coronaryarterial wall in the irritation group without the guidance of the guide-wire.AfterPDL irradiation.the weight of the throm bi was reduced from 1.79±0.23g to0.61±0.12g while in the irritation group theweight of the throm biwas only reducedfrom 1.65±0.19 to 1.42±0.15g.In these two aroups the reduction of throm biweightwere 68%±6% and 15%±7% resoectively(P【0.001).No self-dissolution of thethrom bi occurred in the control group.The finding under the contrast phasem icroscope indicated 91% of the debris size were smaller than the size of redcells.In vivo study,coronary angiography showed that no changes in luminalduam eter of both groups.Nomechanicalor thermal in jury to the coronary arterieswas found excepta light irregularity of the intima.PDL Throm bolysis was effectivein vitro.There was no mechanicaldam age or therm al in jury to the vessels during theprocedure of intracoronary PDL irradiation in vivo.展开更多
The etiology of perinatal arterial ischemic strokes may be maternal, fetal or both. Venous thrombo-embolism is almost always catheter associated in new-borns. Preliminary guidelines for management of perinatal arteria...The etiology of perinatal arterial ischemic strokes may be maternal, fetal or both. Venous thrombo-embolism is almost always catheter associated in new-borns. Preliminary guidelines for management of perinatal arterial ischemic strokes exist but are mostly based on adult studies. We report a unique case of perinatal arterial ischemic stroke, lower extremity arterial and inferior vena-caval thrombosis. Our patient was treated with unfractionated heparin for 10 days then switched to low molecular heparin to complete 6 months of therapy. The patient responded well to therapy and shows minimal signs of permanent neurologic deficits after 6 months.展开更多
950384 Observation of the effectiveness of heparintherapy in patients with chronic idiopathic thrombocy-topenic purpura.SHEN Zhixiang(沈志祥),et al.RuijinHosp,Shanghai 2nd Med Univ,Shanghai,200025.ChinJ Hematol 1995:1...950384 Observation of the effectiveness of heparintherapy in patients with chronic idiopathic thrombocy-topenic purpura.SHEN Zhixiang(沈志祥),et al.RuijinHosp,Shanghai 2nd Med Univ,Shanghai,200025.ChinJ Hematol 1995:16(4)196-197.Fourteen cases (5 males and 9 females,mean age 47years) of chronic idiopathic thrombocytopenic purpura(CITP) were treated with0 low dose of heparin.The ill-ness courses of patients were 6 months to 20 years(mean 6.3years).and all of them were resistant to theconventional corticoth,rapy and other immunosuop-pressive drugs.Heparin was given subcutaneously in展开更多
930164 Molecular pathology study on intherit-ed Glanzmann’s thrombasthenia:A report of 11cases.RUAN Changgeng(阮长耿),et al.InstitHematol,Thrombosis & Hemostasis Res Unit,Suzhou Med Coll,215007.Chin J Intern Med1...930164 Molecular pathology study on intherit-ed Glanzmann’s thrombasthenia:A report of 11cases.RUAN Changgeng(阮长耿),et al.InstitHematol,Thrombosis & Hemostasis Res Unit,Suzhou Med Coll,215007.Chin J Intern Med1992;31(10):639-641.Glycoprotein Ⅱb-Ⅲa(GPⅡb-Ⅲa)concen-tration was studied in 11 patients withGlanzmann’s thrombasthenia(GT)with sensi-tive Western blotting technique.7 patients withsevere GPⅡb-Ⅲa deficiency(less than 10% ofthe normals)were designated as type Ⅰ(64%展开更多
Background The number of mobile stroke programmes has increased with evidence,showing they expedite intravenous thrombolysis.Outstanding questions include whether time savings extend to patients eligible for endovascu...Background The number of mobile stroke programmes has increased with evidence,showing they expedite intravenous thrombolysis.Outstanding questions include whether time savings extend to patients eligible for endovascular therapy and impact clinical outcomes.Objective Our mobile stroke unit(MSU),based at an academic medical centre in upstate New York,launched in October 2018.We reviewed prospective observational data sets over 26 months to identify MSU and non-MSU emergency medical service(EMS)patients who underwent intravenous thrombolysis or endovascular thrombectomy for comparison of angiographic and clinical outcomes.Results Over 568 days in service,the MSU was dispatched 1489 times(2.6/day)and transported 300 patients(20%of dispatches).Intravenous tissue plasminogen activator(tPA)was administered to 57 MSU patients and the average time from 911 call-to tPA was 42.5 min(±9.2),while EMS transported 73 patients who received tPA at 99.4 min(±35.7)(p<0.001).Seven MSU patients(12%)received tPA from 3.5 hours to 4.5 hours since last known well and would likely have been outside the window with EMS care.Endovascular thrombectomy was performed on 21 MSU patients with an average 911 call-to groin puncture time of 99.9 min(±18.1),while EMS transported 54 patients who underwent endovascular thrombectomy(ET)at 133.0 min(±37.0)(p=0.0002).There was no difference between MSU and traditional EMS in modified Rankin score at 90-day clinic follow-up for patients undergoing intravenous thrombolysis or endovascular thrombectomy,whether assessed as a dichotomous or ordinal variable.Conclusions Mobile stroke care expedited both intravenous thrombolysis and endovascular thrombectomy.There is an ongoing need to show improved functional outcomes with MSU care.展开更多
文摘Glanzmann’s thrombasthenia(GT)is an inherited autosomal recessive bleeding disorder,resulting from mutations in the ITGA2B and ITGB3 genes,that lead to a defect in the platelet membrane integrinαIIbβ3.[1]As integrinαIIbβ3 plays an important role in thrombus formation,the clinical manifestation of GT includes bleeding(mostly mucocutaneous)and purpura.For this reason,patients with GT are typically thought to be unlikely to suffer from thromboembolic incidents.Antithrombin is an anticoagulant that inhibits thrombin and is activated factor X and other serine proteases in the coagulation cascade.[2]Antithrombin deficiency is an autosomal dominant hereditary disease with an approximate prevalence of 1/500 in the overall population.[3]In contrast to the hemorrhagic tendency of GT,patients with antithrombin deficiency are at increased risk of thromboembolism,especially in the venous system.Herein,we describe a rare case of GT and antithrombin deficiency coexisting in a single patient.Rivaroxaban was used for the treatment of pulmonary embolism(PE)and deep vein thrombosis(DVT).
文摘The purpose of the study is to evatuate the feasibility of pulsed dye laser(PDL)throm bolysis In vitro and the effect of PDL on vascular function and structure invivo.In vitro,fifty hum an throm biwere divided into laser treated group(n=35),irritation group(n=11),and controgroup(n=4).In the laser treated group thethrom biwere irradiated by PDL with 300 pulses at 100m J/pulse.No irradiation wasgiven to the throm bi in the irritation group,while the catheter was put to and frointo the throm bi for there times,Neither irradintion nor irritation was given to thethrom bi in the controlgroup.Sixteen healthy dogs were studied in vivo.Under theguidance of the guide-w ire PDL catheter was put into the left coronary arteries(n=16)from which PDL was em itted for 1380±60 pulses at 100m J/pulse,whereasthe rightcoronary srteries(n=16)which did not receieve PDL em ission were servedas irritation group.Then the PDL were irradiated directly to the right coronaryarterial wall in the irritation group without the guidance of the guide-wire.AfterPDL irradiation.the weight of the throm bi was reduced from 1.79±0.23g to0.61±0.12g while in the irritation group theweight of the throm biwas only reducedfrom 1.65±0.19 to 1.42±0.15g.In these two aroups the reduction of throm biweightwere 68%±6% and 15%±7% resoectively(P【0.001).No self-dissolution of thethrom bi occurred in the control group.The finding under the contrast phasem icroscope indicated 91% of the debris size were smaller than the size of redcells.In vivo study,coronary angiography showed that no changes in luminalduam eter of both groups.Nomechanicalor thermal in jury to the coronary arterieswas found excepta light irregularity of the intima.PDL Throm bolysis was effectivein vitro.There was no mechanicaldam age or therm al in jury to the vessels during theprocedure of intracoronary PDL irradiation in vivo.
文摘The etiology of perinatal arterial ischemic strokes may be maternal, fetal or both. Venous thrombo-embolism is almost always catheter associated in new-borns. Preliminary guidelines for management of perinatal arterial ischemic strokes exist but are mostly based on adult studies. We report a unique case of perinatal arterial ischemic stroke, lower extremity arterial and inferior vena-caval thrombosis. Our patient was treated with unfractionated heparin for 10 days then switched to low molecular heparin to complete 6 months of therapy. The patient responded well to therapy and shows minimal signs of permanent neurologic deficits after 6 months.
文摘950384 Observation of the effectiveness of heparintherapy in patients with chronic idiopathic thrombocy-topenic purpura.SHEN Zhixiang(沈志祥),et al.RuijinHosp,Shanghai 2nd Med Univ,Shanghai,200025.ChinJ Hematol 1995:16(4)196-197.Fourteen cases (5 males and 9 females,mean age 47years) of chronic idiopathic thrombocytopenic purpura(CITP) were treated with0 low dose of heparin.The ill-ness courses of patients were 6 months to 20 years(mean 6.3years).and all of them were resistant to theconventional corticoth,rapy and other immunosuop-pressive drugs.Heparin was given subcutaneously in
文摘930164 Molecular pathology study on intherit-ed Glanzmann’s thrombasthenia:A report of 11cases.RUAN Changgeng(阮长耿),et al.InstitHematol,Thrombosis & Hemostasis Res Unit,Suzhou Med Coll,215007.Chin J Intern Med1992;31(10):639-641.Glycoprotein Ⅱb-Ⅲa(GPⅡb-Ⅲa)concen-tration was studied in 11 patients withGlanzmann’s thrombasthenia(GT)with sensi-tive Western blotting technique.7 patients withsevere GPⅡb-Ⅲa deficiency(less than 10% ofthe normals)were designated as type Ⅰ(64%
文摘Background The number of mobile stroke programmes has increased with evidence,showing they expedite intravenous thrombolysis.Outstanding questions include whether time savings extend to patients eligible for endovascular therapy and impact clinical outcomes.Objective Our mobile stroke unit(MSU),based at an academic medical centre in upstate New York,launched in October 2018.We reviewed prospective observational data sets over 26 months to identify MSU and non-MSU emergency medical service(EMS)patients who underwent intravenous thrombolysis or endovascular thrombectomy for comparison of angiographic and clinical outcomes.Results Over 568 days in service,the MSU was dispatched 1489 times(2.6/day)and transported 300 patients(20%of dispatches).Intravenous tissue plasminogen activator(tPA)was administered to 57 MSU patients and the average time from 911 call-to tPA was 42.5 min(±9.2),while EMS transported 73 patients who received tPA at 99.4 min(±35.7)(p<0.001).Seven MSU patients(12%)received tPA from 3.5 hours to 4.5 hours since last known well and would likely have been outside the window with EMS care.Endovascular thrombectomy was performed on 21 MSU patients with an average 911 call-to groin puncture time of 99.9 min(±18.1),while EMS transported 54 patients who underwent endovascular thrombectomy(ET)at 133.0 min(±37.0)(p=0.0002).There was no difference between MSU and traditional EMS in modified Rankin score at 90-day clinic follow-up for patients undergoing intravenous thrombolysis or endovascular thrombectomy,whether assessed as a dichotomous or ordinal variable.Conclusions Mobile stroke care expedited both intravenous thrombolysis and endovascular thrombectomy.There is an ongoing need to show improved functional outcomes with MSU care.
