Short Communication Effect of sulfated polysaccharides on hepatocyte adhesion

The effects of sulfated polysaccharides on hepatocyte adhesion on the polystyrene dish and fibronectin-coated dish were investigated. Dextran sulfate and synthetic mannopyranan sulfate slightly inhibited hepatocyte adhesion on fibronectin-coated dish, while heparin showed no effect. On the other hand, hepatocyte adhesion on polystyrene dishes was stimulated in the presence of sulfated polysaccharides in the medium.     

Possible pro‐inflammatory role of heparin‐binding epidermal growth factor‐like growth factor in the active phase of systemic sclerosis

Heparin‐binding epidermal growth factor (EGF)‐like growth factor (HB‐EGF) is a member of the EGF family growth factors, which affects multiple aspects of the wound healing process such as epithelialization, wound contraction and angiogenesis. In our study, we measured the serum HB‐EGF levels of 51 systemic sclerosis (SSc) patients, which showed a significant increase compared with those of 20 normal subjects. Further analysis revealed a positive correlation between the HB‐EGF level and pulmonary ground‐glass score but no correlation between the former and pulmonary fibrosis score. Other findings include: a significant increase of serum sialylated carbohydrate antigen KL‐6 levels and significant shortness of disease duration in the diffuse cutaneous SSc patients with elevated HB‐EGF levels; and significantly higher HB‐EGF levels in the presence of Raynaud's phenomenon, in that of telangiectasia, and in the absence of contracture of phalanges in all SSc patients. We then evaluated HB‐EGF mRNA levels of fibroblasts harvested from skin samples of the SSc patients and those of foreskin‐derived fibroblasts treated with transforming growth factor‐β, both of which were significantly higher than each control. In conclusion, we speculate that HB‐EGF plays a pro‐inflammatory role in the active skin and lung lesions of SSc.     

注射低分子肝素致皮下出血的原因分析与护理进展（综述）

注射低分子肝素造成患者皮下出血是常见的不良反应，该文从注射前、注射时、注射后三个阶段分析了注射低分子肝素致皮下出血的相关因素，并针对相关因素提出护理改进措施，旨在降低注射所致皮下出血发生率。     

Single vs multivessel treatment during primary angioplasty: results of the multicentre randomised HEpacoat™ for cuLPrit or multivessel stenting for Acute Myocardial Infarction (HELP AMI) Study

DESIGN: Prospective randomized, multicentre study. RATIONALE: Recanalisation of the culprit lesion is the main goal of primary angioplasty for acute myocardial infarction. With the exception of cardiogenic shock, staged procedures are performed in the presence of multivessel disease. The study hypothesis is that with modern non-thrombogenic stents (heparin coated) complete revascularization with multivessel treatment can be safely achieved during the primary angioplasty procedure with a lower need of subsequent revascularization procedures and at a lower cost. ENDPOINTS: PRIMARY: 12-month incidence of repeat revascularization (any revascularization, infarct related artery as well as non-infarct-related artery). SECONDARY: (1) in hospital repeat revascularization, reinfarction and death; (2) total hospital cost (including a 12 months follow-up period). METHODS: 69 patients with ST elevation Acute Myocardial Infarction (AMI), <12 hours after symptoms onset, undergoing primary angioplasty, with documented multivessel disease and both culprit lesion and 1 to 3 other lesions suitable for stent implantation. Unbalanced randomization between culprit lesion treatment only ( n??=?17) and complete multivessel treatment (n?=?52, with 71 additional lesions treated).RESULTS: The two groups were well balanced in terms of clinical characteristics, number of diseased vessels and angiographic characteristics of the culprit lesion. In the complete multivessel treatment group 2.36?±?0.64 lesions per patient were treated using 2.73?±?0.78 heparin coated stents (1.00 lesions and 1.29?±?0.61 stents in the culprit treatment group, bothp?<?0.001). The duration of the procedure increased from 53?±?21?min (culprit treatment group) to 69?±?32?min (p?=?0.032) and the amount of contrast used from 242?±?102?ml (culprit treatment group) to 341?± 163?ml (multivessel complete treatment),p?=?0.025. A similar low incidence of in-hospital major adverse cardiac events was observed in the 2 groups (0 and 3.8% in culprit and multivessel treatment groups,p?=?0.164). The increase in the incidence of new revascularisation in the culprit treatment group at 12 month follow-up was not significant (35 vs 17%,p?=?0.247) but was sufficient to compensate the initial higher in-hospital cost, with a similar 12 month hospital cost in the 2 groups (€22 330?±?€13 653 vs €20 382?±?€11 671,p?=?0.231).CONCLUSION: Multivessel treatment during primary PTCA was safe in this controlled trial. However, when only the culprit lesion was initially treated, the need for subsequent clinically driven revascularization remained low and no clinical or economical advantages were obtainable with a more aggressive initial approach. In clinical practice, a staged approach to multivessel treatment during primary angioplasty avoids to treat unnecessarily non clinically relevant lesions. (Int J Cardiovasc Intervent 2004; 6: 128-133)     

Transcapillary escape rate and albuminuria in Type II diabetes. Effects of short-term treatment with low-molecular weight heparin (Short Communication)

Summary The relation between urinary albumin excretion rate (UAE), transcapillary escape rate of albumin (TER_alb), haemostatic factors, ambulatory blood pressure, and metabolic variables was investigated in 45 Type II (non-insulin-dependent) diabetic patients without overt nephropathy or uncontrolled blood pressure. We enrolled 44 patients in a placebo controlled study to test the effects of 3 week long treatment with low-molecular weight heparin (tinzaparin) on the same variables. BMI, 24 h systolic and diastolic blood pressure, plasma concentrations of triglycerides, fasting glucose, factor VIII, von Willebrand factor (vWf), fibrinogen, α-2 macroglobulin, and fibronectin were notably higher in patients with increased albuminuria compared with normoalbuminuric patients, whereas the TER_alb was similar in the two groups. TER_alb correlated with fasting plasma glucose. UAE correlated more closely than TER_alb with 24 h ambulatory blood pressure, vWf, and factor VIII. Urinary albumin excretion rate was unchanged during tinzaparin [28.9 ± 5.6 vs 28.1 ± 6.0 μg/min (geometric mean (antilog SD)] vs placebo (18.0 ± 5.4 vs 17.6 ± 5.3 μg/min), and no change was found in TER_alb [6.3 ± 1.6 vs 6.0 ± 1.5 %/h (means ± SD), and 6.3 ± 1.5 vs 5.6 ± 1.8 %/h; tinzaparin versus placebo, respectively]. Only minor changes were observed in blood pressure, lipids, glycaemic control and haemostatic factors. This study shows no correlation between albuminuria and transcapillary escape rate in Type II diabetic patients without overt nephropathy or uncontrolled blood pressure. UAE is related to markers of atherosclerosis, endothelial injury and dysfunction, and haemostatic factors. Moreover, UAE correlates much more than TER_alb with 24 h ambulatory blood pressure, von Willebrand factor, and factor VIII. Finally, short-term treatment with tinzaparin does not change the transvascular or glomerular leakage of albumin. These results indicate that TER_alb is not a sensitive marker of microvascular dysfunction in such patients and that factors other than abnormal glycosaminoglycan metabolism may contribute to the vascular damage of these patients. [Diabetalogia (1999) 42: 60–67] Received: 2 February 1998 and in final revised form: 1 September 1998     

探讨低分子肝素预防下肢静脉曲张术后深静脉血栓形成的临床效果

目的：分析低分子肝素预防下肢静脉曲张术后深静脉血栓形成的临床效果。方法随机选择2012年1月-2014年1月在该院行分段剥脱术+腔内激光闭合术+大隐静脉高位结扎的下肢静脉曲张患者400例,将其随机分成实验组和对照组各200例,对照组患者术后不给于抗凝药物,实验组患者术后给予低分子肝素进行预防治疗,对两组患者深静脉血栓形成和并发症发生情况进行对比分析。结果在浸透敷料出血、切口出血、血小板减少以及肝功能异常发生率方面,两组患者比较差异无统计学意义(P>0.05);实验组患者深静脉血栓形成发生率显著低于对照组患者,两者比较差异有统计学意义(P<0.05)。术后随访发现,两组患者在下肢静脉曲张复发率和隐神经损伤发生率方面比较差异无统计学意义(P>0.05)。结论在对下肢静脉曲张术后深静脉血栓形成进行预防时,低分子肝素具有比较好的临床效果,而且安全性高,应该进行临床推广和应用。     

血清肝素辅助因子II 活性与下肢动脉硬化闭塞症介入术后再狭窄相关

目的：观察血清肝素辅助因子II(heparin cofactor II,HC II)活性与下肢动脉硬化闭塞症介入术后再狭窄的 关系。方法：因股浅动脉闭塞性疾病而成功施行支架植入术的患者62例,根据患者血清HC II活性高低,将患者分为 两组：HC II活性≥100%组(n=40)及HC II活性<100%组(n=22)。收集患者相关临床资料,随访观察6个月,观察术后 支架内狭窄、闭塞情况。结果：两组患者基线资料比较差异无统计学意义(P>0.05)。随访至第6个月月末时,HC II活 性<100%组支架内再狭窄程度较HC II活性≥100%组严重(P<0.05)。HC II活性<100%组支架内再狭窄发生率较HC II活 性≥100%组高(P<0.05)。进一步对危险因素行多元回归分析,结果显示血清HC II活性升高是减少术后再狭窄发生的 独立因素(OR=0.982,P=0.048)。结论：血清HC II活性与下肢动脉硬化症介入术后再狭窄相关;HC II活性越低,术后 发生再狭窄的危险越大。