Preparation,characterization, and antibacterial activity of diclofenac-loaded chitosan nanoparticles

Emerging antibiotic resistance necessitates the development of new therapeutic approaches. Many studies have reported the antimicrobial activity of diclofenac sodium (DIC) and chitosan nanoparticles (CNPs). Hence, this study aimed to prepare non-antibiotic DIC-loaded CNPs (DIC.CNPs) and characterize their in vitro antibacterial activity. DIC.CNPs were prepared from low and high molecular weight (LMW and HMW, respectively) chitosan using an ionic gelation method. Prepared NPs were characterized, and their antibacterial activity against gram-positive Staphylococcus aureus and Bacillus subtilis was evaluated using the agar diffusion and broth dilution methods. The particle size, polydispersity index (PDI), and encapsulation efficiency of the formulated DIC.CNPs increased with increasing MW of chitosan. The prepared NPs showed a narrow size distribution with low PDI values (0.18 and 0.24) and encapsulation efficiency (29.3% and 31.1%) for LMW.DIC.CNPs and HMW.DIC.CNPs, respectively. The in vitro release profile of DIC from the DIC.CNPs was biphasic with a burst release followed by slow release and was influenced by the MW of chitosan. DIC.CNPs exhibited significantly higher antibacterial activity against S. aureus (minimum inhibitory concentration [MIC₉₀] _LMW.DIC.CNPs?=?35?µg/mL and MIC_{90 HMW.DIC.CNPs}?=?18?µg/mL) and B. subtilis (MIC_{90 LMW.DIC.CNPs}?=?17.5?µg/mL and MIC_{90 HMW.DIC.CNPs}?=?9?µg/mL) than DIC alone did (MIC_{90 DIC}?=?250 and 50?µg/mL against S. aureus and B. subtilis, respectively). The antibacterial activity was influenced by pH and the MW of chitosan. Collectively, these results may suggest the potential usefulness of DIC.CNPs as non-antibiotic antibacterial agent necessitating further future studies to asses the stability of DIC.CNPs prepared.     

Plasma tissue factor and tissue factor pathway inhibitor levels in patients with disseminated intravascular coagulation

We measured the plasma levels of tissue factor (TF) and tissue factor pathway inhibitor (TFPI) in patients with disseminated intravascular coagulation (DIC) to examine the relationship between TFPI and vascular endothelial cell injury. Plasma TF (273 ± 90 pg/ml) and TFPI (252 ± 125 ng/ml) levels were significantly increased in patients with DIC compared with non-DIC patients. Plasma TF antigen level was significantly increased in pre-DIC patients (285 ± 85 pg/ml), while the plasma TFPI level (152 ± 54 ng/ml) was not markedly increased in such a state. The plasma TF/TFPI ratio was high in the pre-DIC patients (2.10 ± 0.90), and low in the DIC patients (1.40 ± 0.87) and healthy volunteers (0.84 ± 0.26). There was no significant difference between the DIC patients with a good outcome and those with a poor outcome in terms of plasma TF levels, although the plasma TFPI level in the DIC patients with a good outcome (289 ± 133 ng/ml) was significantly higher than that in those with a poor outcome (187 ± 75 ng/ml). During the clinical course of DIC, plasma TF antigen was increased first, and an increase of the plasma TFPI level followed the increase in plasma TF level. These findings suggest that plasma TFPI is released from vascular endothelial cells and it may reflect vascular endothelial cell injury. It is conceivable that TF and TFPI may play an important role in the onset of DIC. © 1996 Wiley-Liss, Inc.     

胎盘早剥并DIC 13例急救及护理

对13例胎盘早剥并DIC患者行积极抢救及护理,给予密切监测生命体征、并发症观察及护理、严格记录出入液量、积极防治DIC、切口护理、心理护理、饮食指导等.结果本组行剖宫产终止妊娠治愈8例;子宫全切术治愈3例.新生儿均健康.因多器官功能衰竭死亡2例.认为精心的急救及护理措施是挽救患者生命、提高治疗效果的重要保障.     

临产孕妇产前及产后凝血功能检测及其临床意义

了解临产孕妇及产后凝血状态,预防孕妇在分娩过程中及产后大出血而导致的急性D IC及血栓栓塞性疾病的发生。采用日本生产的Sysm ex CA-530全自动血凝分析仪,对我院产科145例临产孕妇产前及产后和35例正常非妊娠妇女,使用真空管静脉采血后,进行凝血酶原时间（PT）、活化部分凝血酶原时间（APTT）、凝血酶时间（TT）和纤维蛋白原（FIB）的检测。临产孕妇产前凝血四项与健康对照组比较差异有统计学意义（P〈0.01）,PT、APTT、TT明显短于健康对照组,FIB明显高于健康对照组;产后凝血四项与健康对照组差异无统计学意义（P〉0.05）。临产孕妇产前血液处于高凝状态,产后72h恢复。对临产孕妇产前及产后联合检测凝血四项指标并动态观察,能较全面、完整地反映孕妇产前及产后凝血功能情况,对预防和治疗孕妇在分娩过程中及产后出血和评估预后具有重要的临床意义。     

凝血及纤溶指标在弥散性血管内凝血产妇中的临床应用

目的探讨凝血及纤溶指标在弥散性血管内凝血（DIC）产妇中的临床应用价值。方法选择2009年1月至2012年8月收治的28例产科DIC产妇为观察对象,DIC患者治疗前和治疗后分别进行D-二聚体（DD）、纤维蛋白原（FIB）、活化部分凝血活酶时间（APTT）、血小板计数（PLT）的测定,并进行对比。结果28例发生DIC的产妇治疗前DD明显上升,FIB减少,APTT延长,PLT进行性下降,治疗后各指标明显改善,与治疗前比较,差异有统计学意义（P〈0．05）。结论动态检测D-D、FIB、APTT、PLT对产科DIC的诊治具有一定的意义,有助于临床诊断和监测患者预后。     

急诊介入栓塞止血治疗产后大出血临床研究

目的：探讨产后大出血急诊介入栓塞止血的价值。方法：本组27例产后大出血，出血量1000－5000ml，出血原因为：中央型前置胎盘，宫颈妊娠，产后，胎盘粘连和滞留，宫缩乏力，妊娠高血压综合征（妊高征），凝血功能联障碍等，多数患者为复合笥因素。经临床紧急抢救，输血，抗体克，清宫，使用宫缩剂，止血剂，缝合或（和）阴道填塞止血等处理，难于控制出血者急诊介入栓塞止血，采用超选择髂内动脉前支插管，造影明确诊断后用明胶海绵条或碎片栓塞靶动脉。结果：插管成功率96．3％，发现1例异位子宫动脉。栓塞后立即止血22例（81．5％），渐止血4例（14．81％），总有效率96．3％。8例合并产后DIC，其中1例伴有多脏器损伤；11例失血性休克均抢救成功。1例插管未找到子宫动脉，而改作子宫切除术。本组无栓塞并发症及病死率。结论：急诊介入栓塞止血是抢救危及生命的产后大出血的理想方法，不仅能抢救产妇的生命，而且能保留产妇子宫，对抢救产后DIC也有良效，值得推广应用。     

急性弥散性血管内凝血20例临床分析

目的掌握急性弥散性血管内凝血（DIC）临床特点及诊治原则。方法通过分析20例DIC临床资料及实验室检查结果,以各参数指标确定诊断标准。结果20例中,12例经相关治疗后治愈,8例死亡。结论对于DIC病例应按临床诊断标准争取早期确诊,即时行抗凝治疗,大部分病例可治愈。     

Current Clinical Practice DIC 2002: A Review of Disseminated Intravascular Coagulation

The turn of the millennium has seen clear advances in the understanding and management of Disseminated Intravascular Coagulation (DIC). The recognition that its pathogenesis stems from sustained thrombin generation in fuelling the cycle between inflammation and coagulation has seen the first successful treatment in severe sepsis through targeting this activity. An advance in treatment brings heightened relevance to laboratory testing, which now emphasises earlier detection and better monitoring to facilitate improved risk-identification and assessment of therapeutic efficacy. This review article also provides insights into future strategies that might build on the foundation of improving prognosis for the patient with DIC.     

DIC的病理生理研究进展

DIC是一种源于微血管损伤并且可导致微血管损伤的获得性凝血紊乱综合征，不同的机制在止血系统的不同环节同时促使凝血活化，其中炎性介质和细胞因子的释放是其中心环节。