低分子肝素钙联合山莨菪碱治疗早发型重度子痫前期的疗效观察

目的探讨低分子肝素钙联合山莨菪碱治疗早发型重度子痫前期的临床疗效。方法选取2011年6月—2017年6月在西北妇女儿童医院治疗的早发型重度子痫前期患者156例为研究对象,随机分为对照组(78例)和治疗组(78例))。对照组患者肌内注射盐酸消旋山莨菪碱注射液,10 mg/次,2次/d。治疗组在对照组的基础上腹壁皮下注射低分子肝素钙注射液,2 050 AXa IU/次,2次/d。两组患者连续治疗1周。比较两组的血压、肾功能指标、妊娠结局及妊娠并发症情况。结果治疗后,对照组收缩压和平均动脉压明显下降,治疗组收缩压、舒张压和平均动脉压均明显下降,同组治疗前后比较差异具有统计学意义(P0.05);治疗后,治疗组患者舒张压和平均动脉压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,两组患者24 h尿蛋白、尿酸(UA)、尿素氮(BUN)、血肌酐(Scr)水平均显著降低,同组治疗前后比较差异具有统计学意义(P0.05);且治疗组患者比对照组降低更明显,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组患者的新生儿体质量、存活数、分娩孕周和延长孕龄天数均明显优于对照组患者,两组比较差异具有统计学意义(P0.05)。对照组和治疗组并发症的发生率分别为15.18%、7.59%,两组比较差异具有统计学意义(P0.05)。结论低分子肝素钙联合山莨菪碱治疗早发型重度子痫前期具有较好的临床疗效,具有一定的临床推广应用价值。     

低分子肝素钙并单硝酸异山梨酯治疗肺心病心衰疗效分析

慢性肺源性心脏病(肺心病)是临床常见危重症之一,往往可进一步发展为肺心病心力衰竭。肺心病患者由于慢性缺氧引起代偿性红细胞增多,使血液粘滞度明显增加,从而造成肺动脉压力的增高及通气/血流比例的严重失调,进一步加重缺氧,导致严重的右心衰竭或全心衰竭,此为慢性肺源性心脏     

不同剂量肝素治疗病毒性肝炎高胆红素血症疗效分析

目的观察不同剂量肝素治疗病毒性肝炎高胆红素的的疗效。方法选取235例病毒肝炎患者随机分为甲、乙、丙三组分别用肝素33mg、50mg、及100mg加入低分子右旋糖肝500mL中静脉注射,1次/d,疗程为4周。结果甲、乙、丙三组各自与治疗前SB相比,差异有显著性(P<0.01),乙、丙两组治疗后SB与甲组治疗后SB相比,差异有显著性(P<0.01),乙、丙两组间治疗后,SB差异无显著性(P>0.05),乙、丙两组与甲组相比,总有效率差异有显著性(P<0.05),乙、丙两组间相比,总有效率差异无显著性(P>0.05)。     

以QC小组活动助力服务质量提升——降低低分子肝素钙皮下注射瘀青率

目的 降低低分子肝素钙皮下注射瘀青率.方法 QC小组活动.结果 低分子肝素钙皮下注射瘀青率由活动前的33.1％降低到活动后的6.1％,达到了活动目标,提高了护理质量,提升了患者满意度.     

低分子肝素对肝癌生长和转移抑制作用的研究

目的　研究低分子肝素对肝癌生长和转移的抑制作用。方法　建立人肝癌裸鼠动物模型 (LCI D2 0 )。术后第一天起分别予腹腔内注射生理盐水 (对照组 )、顺铂 氟尿嘧啶 (化疗组 )、皮下注射法安明 (低分子肝素组 )、顺铂、氟尿嘧啶与法安明联合应用 (联合组 ) ,连续 5周。测量原位肿瘤大小、观察肿瘤腹壁、其他脏器转移及腹水情况 ;肿瘤组织中微血管密度 (microvesseldensity,MVD)、血管内皮生长因子 (vascularendothelialgrowthfactor,VEGF)、平滑肌肌动蛋白 (smoothmuscleactin ,SMA) ;测定血清AFP、CEA、CA199。结果　低分子肝素组肿瘤体积、MVD、SMA、肝、肺、腹壁转移率及腹水形成率明显低于对照组 (P <0 0 5 ) ,抑瘤率明显高于对照组 (P <0 0 5 )。结论　低分子肝素对肝癌的生长与转移具有抑制作用 ,该作用与抑制肿瘤血管形成有关。     

急性脑梗死溶栓后应用低分子肝素治疗临床研究

目的 :观察急性脑梗死溶栓后应用低分子肝素治疗临床效果与可行性。方法 :选取急性脑梗死溶栓后病人 5 2例 ,随机分为治疗组 (n =2 6 )与对照组 (n =2 6 )。对照组给予常规治疗。治疗组在常规治疗的基础上于溶栓 2h内给予低分子肝素治疗 ,疗程 7d。结果 :治疗组总显效率 (基本治愈 +显著进步 )明显优于对照组 (P<0 .0 1) ,神经功能平分下降显著高于对照组 (P <0 .0 1)。并且无并发深静脉血栓 (DVT)者 ,未发现自发性出血及其他不良反应。结论 :急性脑梗死溶栓后应用低分子肝素治疗 ,能预防再梗死 ,显著减少梗死病人DVT的发病率。改善病人预后且安全可靠、简便易用 ,值得临床进一步推广应用。     

In vitro comparison of dabigatran, unfractionated heparin, and low-molecular-weight heparin in preventing thrombus formation on mechanical heart valves

Introduction

Lifelong oral anticoagulation (OAC) therapy is required for the prevention of thromboembolic events after implantation of an artificial heart valve. Thromboembolism and anticoagulant-related bleedings account for ≈ 75% of all complications experienced by heart valve recipients (2-9% of patients per year). The present study investigated the efficacy of dabigatran, a new direct thrombin inhibitor for oral use, as compared to unfractionated heparin (UFH) and low-molecular-weight heparin (LMWH) in preventing thrombus formation on mechanical heart valves in vitro.

Material and Methods

Blood (230 ml) from healthy young male volunteers was anticoagulated either by dabigatran (1 μmol/l), UFH (150 IU), or LMWH (100 IU). Mechanical heart valve prostheses were placed in an in vitro thrombosis tester and exposed to the anticoagulated blood samples under continuous circulation at a rate of 75 beats per minute.

Results

In whole blood with no anticoagulant, the apparatus completely clotted in 15-20 minutes. When blood was treated with dabigatran, the mean thrombus weight was 164 ± 55 mg, in the UFH group 159 ± 69 mg, and in the LMWH group 182 ± 82 mg (p-value: 0.704). Electron microscopy showed no significant difference in thrombus formation in any group.

Conclusisons

Dabigatran was as effective as UFH and LMWH in preventing thrombus formation on mechanical heart valves in our in vitro investigation. Thus, we hypothesize that dabigatran etexilate might potentially be a useful and competitive orally administered alternative to UFH and LMWH for recipients of alloplastic heart valve prostheses.     

利伐沙班治疗老年恶性肿瘤并发下肢深静脉血栓的疗效观察

目的：观察利伐沙班治疗老年恶性肿瘤并发下肢深静脉血栓（DVT）的疗效及安全性。方法选取2011年12月—2014年12月在桂林医学院附属医院治疗的老年恶性肿瘤并发DVT患者76例,随机分成对照组和治疗组,每组38例。对照组sc低分子肝素钙注射液4250 U/次,1次/d。治疗组口服利伐沙班片,1片/次,1次/d。两组均连续治疗24 d。观察两组患者的临床疗效,同时比较两组治疗前后下肢周径差、血流速度的变化,同时检测用药后 D-二聚体、活化部分凝血活酶时间（APTT）、凝血酶原时间（PT）等指标,评估药物的安全性。结果治疗后,对照组和治疗组总有效率分别为86.84%、97.37%,两组比较差异具有统计学意义（P＜0.05）。治疗后,两组患者下肢周径差显著缩小,同时血流速度显著升高,同组治疗前后差异有统计学意义（P＜0.05）;且治疗组这两个指标的改善程度优于对照组,两组比较差异有统计学意义（P＜0.05）。治疗后,两组患者PT、APTT差异无统计学意义,治疗组D-二聚体显著低于对照组,差异有统计学意义（P＜0.05）。两组均没有出血患者。结论利伐沙班治疗老年恶性肿瘤并发下肢深静脉血栓疗效确切,同时具有良好的安全性,不会增加出血的不良事件。     

Heparin-induced thrombocytopenia: a rare manifestation in a case of uncemented total hip replacement and review of the literature

Purpose  Heparin-induced thrombocytopenia (HIT) is a rare manifestation-complication after the use of low-molecular heparins. In this case report we present a case of HIT following an uncemented hip replacement. Method  A 61-year-old male patient with insignificant medical history, suffering from a right hip arthritis underwent an uncomplicated hip replacement and was discharged with normal blood tests a week later. Results  The HIT syndrome started to manifest 1 day after discharge, and as the symptoms are similar to pulmonary embolism, the patient was readmitted for further investigation. The blood tests revealed a major decline of PLT levels, IgG against heparin and positive D-dimers. Cardiac ultrasound was suggestive of pulmonary embolism. Vein triplex showed iliac and femoropopliteal deep vein thrombosis. The use of low-molecular heparin was discontinued and Lepuridin was administered. The patient was discharged 20 days later and was followed up regularly. During the last re-examination he was asymptomatic and his blood tests were normal. Conclusion  HIT syndrome has similar manifestation to pulmonary embolism and may be misdiagnosed. Early diagnosis renders the condition reversible, whereas delayed recognition may be life threatening.     

Pro- and anti-angiogenic agents

The vascular endothelium has been characterized in every organ system, and is described as a selective permeable barrier and as a dynamic and disseminated organ with endocrine function. These activities have been shown to result from the interactions of ligands with membrane-bound receptors as well as through specific junctional proteins and receptors that govern cell-cell interactions. The endothelial cells' movement (e.g., angiogenesis) has been hypothesized to occur following the release of stimuli that could promote the formation of new blood vessels. Angiogenesis has also been reported to be the continued expansion of the vascular tree in avascular regions, as a result of the sprouting of endothelial cells from existing vessels. Most commonly, angiogenesis has been characterized during wound healing and tumour growth. Herein we summarize and discuss the latest results from fundamental laboratory research aimed at proving a link between the proliferation of cancer and angiogenesis, as well as the new rationale around novel pro- and anti-angiogenic molecules.