肝素钠细菌内毒素检查法的建立

目的: 建立肝素钠原料药的细菌内毒素检查方法.方法: 通过干扰评价试验,证明肝素钠对细菌内毒素检查有抑制作用,使用稀释剂(I)适当补充二价阳离子,对样品作适当稀释,以消除其干扰抑制作用.结果: 补充适量的二价阳离子可以消除干扰作用.结论: 肝素钠原料药可以建立细菌内毒素检查法.     

小剂量肝素治疗肺癌患者血栓前状态的临床研究

报道７５例中、晚期肺癌血栓前状态Ｄ－二聚体在治疗过程中的变化情况。小剂量肝素加化疗加／或放疗治疗组４０例，Ｄ－二聚体转正常３２例、有效率（８０％）。化疗加／或放射治疗（无肝素组）３５例，Ｄ－二聚体转正常６例，有效率１７．１％（Ｐ＜０．０１）。观察结果表明：小剂量肝素治疗中、晚期肺癌血栓前状态是一种有效、安全的方法。     

低分子肝素对糖尿病大鼠肾脏的保护作用

目的探讨低分子肝素对糖尿病大鼠肾脏的保护作用。方法将实验动物随机分为正常对照组、糖尿病组以及低分子肝素治疗组。低分子肝素治疗组给予低分子肝素(1 mg.kg-1.d-1)治疗。8周后检测各组大鼠尿蛋白排泄率、血糖、血脂以及PT与KPTT,测定血浆P-selectin表达水平,观察组织病理学变化。结果低分子肝素治疗组尿蛋白排泄率(P<0.01)、高凝程度(P<0.05)、血脂水平(P<0.01)以及P-selectin表达(P<0.01)均低于糖尿病组,肾组织病理改变亦明显较轻。结论低分子肝素对2型糖尿病大鼠肾脏有保护作用,可能与抑制P-selectin的表达有关。     

血液透析患者普通肝素与低分子肝素抗凝血小板参数变化

目的探讨维持血液透析患者应用不同分子量肝素抗凝血小板参数变化。方法测定26例应用普通肝素(UFH)及38例应用低分子量肝素(LMWH)抗凝的血液透析患者血小板数量(PLT)及血小板平均体积(MPV),并进行对比,分别与30例健康体检者PLT及MPV进行比较。测定并比较18例患者自UFH改为LMWH抗凝3个月PLT及MPV的变化。结果UFH组PLT及MPV低于对照组(P<0.01);LMWH组PLT及MPV低于对照组,差异有显著意义(P<0.05);在UFH组及LMWH组间,后者PLT及MPV高于前者,(P<0.05);自UFH改为LMWH抗凝后,PLT及MPV有升高,但差异无显著意义(P>0.05)。结论肝素抗凝可致PLT及MPV下降,UFH尤其显著;UFH抗凝致PLT及MPV下降后改用LMWH抗凝并不能使PLT及MPV有明显上升。     

Pregnancy complicated with Buerger's disease.

Buerger's disease is an inflammatory occlusive vascular disorder involving small- and medium-sized arteries in the distal extremities and is usually complicated with thrombophlebitis. Since Buerger's disease develops most frequently in men who smoke, pregnancy complicated with this disease is extremely rare. Only three pregnancies have been reported previously. All cases indicate that Buerger's disease worsens during pregnancy. However, anti-coagulant therapy appeared to be effective in this case. Accordingly, careful observation is mandatory in pregnancies complicated with Buerger's disease.     

可来福接头在深静脉置管中应用

目的 观察可来福接头在深静脉置管中的应用优势，方法 对260例深静脉置管成功的患者分别采用可来福接头及肝素帽封管，随机分为两组，160例采用可来福接头，100例采用肝素帽，、观察回血、堵管情况及留置时间。结果 可来福接头明显优于肝素帽。结论 可来福接头输液简便易行，节省时间，减少耗材。     

Crystal structures of thrombin and thrombin complexes as a framework for antithrombotic drug design

Summary The wealth of structural information now available on thrombin, its precursors, its substrates and its inhibitors allows a rationalization of its many roles. -Thrombin exhibits an unusually deep and narrow active-site cleft, formed by loop insertions that are characteristic of thrombin. This canyon structure is one of the prime causes for the narrow specificity of thrombin. As a result of the conjunction of amino acid residues with similar properties such as charge or hydrophobicity, thrombin can be divided up into a number of functional regions. The apposition of the active site to a hydrophobic pocket (the apolar binding site) on one side and a basic patch (the fibrinogen recognition exosite) on the other allows for a fine-tuning of enzymatic activity, as seen for fibrinogen. These two sites are also optimally used by the leech-derived inhibitor hirudin, allowing the very tight binding observed; thrombin inhibition is effected by blocking access to the active site. Interactions with antithrombin III are tightened with the help of heparin, which binds to a second basic site (the heparin binding site). Non-proteolytic cellular properties are attributed to the rigid insertion loop at Tyr^60A. The observed rigidity of the thrombin molecule in its complexes makes thrombin ideal for structure-based drug design. Thrombin can be inhibited either at the active site or at the fibrinogen recognition exosite, or both. Structural information shows that binding at the former is enhanced by good fit of aromatic moieties to the aryl and S2 binding sites (the apolar binding site). Binding at the fibrinogen recognition exosite is facilitated by negatively charged groups. The unpredictable nature of inhibitor binding underlines the importance of experimental monitoring of structures of thrombin inhibitors in the drug design process.     

叶酸联合低分子肝素和小剂量阿司匹林治疗复发性流产的临床研究

目的探讨叶酸片联合低分子肝素钙注射液和小剂量阿司匹林肠溶片治疗复发性流产的临床疗效。方法选取2016年1月—2016年8月绵阳中心医院收治的复发性流产患者94例为研究对象,按照数表法将患者随机分为对照组和治疗组,每组各47例。对照组皮下注射低分子肝素钙注射液,5 000 IU/次,1次/d;且口服阿司匹林肠溶片,75 mg/次,1次/d。治疗组在对照组基础上口服叶酸片,0.4 mg/次,1次/d。所有患者均于确定妊娠后开始治疗,并持续至临产或发生流产、早产。观察两组的临床疗效,比较两组的激素水平、凝血指标、叶酸和同型半胱氨酸(HCY)的情况。结果治疗后,对照组、治疗组的活产率分别为85.11%、93.62%,两组活产率比较差异无统计学意义。治疗后,两组人绒毛膜促性腺激素(HCG)、孕酮(P)、雌二醇(E2)水平均显著升高,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标明显高于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组血浆纤溶酶原激活物抑制剂-1(PAI-1)水平明显降低,治疗前后比较差异有统计学意义(P0.05);且治疗组PAI-1水平明显低于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组HCY水平明显下降,而叶酸水平明显升高,治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P0.05)。结论叶酸片联合低分子肝素钙注射液和小剂量阿司匹林肠溶片治疗复发性流产具有较好的临床疗效,可改善激素水平,降低PAI-1和HCY水平,具有一定的临床推广应用价值。     

体外血脂分离术血脂分离效果观察

目的探讨采用体外肝素诱导低密度脂蛋白形成复合物沉淀而使血脂被分离的方法 (HELP)对低密度脂蛋白(LDL C)、总胆固醇 (TCH)、甘油三酯 (TG)、载脂蛋白A(ApoA)、载脂蛋白B(ApoB)和高密度脂蛋白胆固醇 (HDL C)的分离清除的效果。方法用HELP血脂分离仪在体外肝素诱导LDL C、脂蛋白、纤维蛋白原、甘油三酯 ,形成肝素 LDL C 纤维蛋白原复合物而被沉淀分离出来。结果血脂分离术后患者血脂各项指标比术前下降的百分率分别是ApoA 2 4 .50 % ,ApoB 49.1 5 % ,LDL C 50 .33 % ,TCH 51 .40 % ,TG 54 .1 7% ,LDL C 64 .1 1 %。血脂分离术前后血清血脂测定结果比较 ,各测定指标显著降低 (P <0 .0 0 1 )。其中 3例术后 1个月复查血清LDL C、TCH、TG结果与术前结果比较无显著性差异。结论体外血脂分离术可以达到分离清除血浆中部分血脂的目的     

肝纤维化大鼠的肝素干预治疗观察

目的：建立肝纤维化大鼠模型,对肝素的抗肝纤维化疗效进行评价。方法: 应用CCl₄建立肝纤维化大鼠模型,分别给予不同剂量的肝素进行抗肝纤维化干预治疗。8周后处死大鼠,留取血清检测透明质酸、Ⅳ型胶原、层连蛋白、Ⅲ型前胶原、转化生长因子β₁等。留取肝组织,行HE和网织纤维染色,采用免疫组织化学方法检测肝组织中转化生长因子β₁的表达,电子显微镜下观察HSC的超微结构变化及狄氏腔内胶原纤维沉积情况。结果: 肝素预防性治疗组和肝素治疗组的各项血清学指标水平与肝纤维化大鼠造模组相比,差异均有统计学意义（P<0.001,P<0.01）。网织纤维染色显示,肝素可明显抑制纤维增生。肝素可以降低血清转化生长因子β₁水平,与免疫组织化学染色结果一致。电镜下可见肝素治疗后狄氏腔内胶原纤维沉积减少。结论: 肝素具有抗肝纤维化作用,其作用机制与抑制转化生长因子β₁表达有关。