Blood Fibrinogen Levels Research Articles

Value of peripheral blood albumin and fibrinogen levels in the prognostic evaluation of advanced non-small cell lung cancer

Objective To investigate the clinical prognostic value of peripheral blood albumin and fibrinogen levels in advanced non-small cell lung cancer (NSCLC). Methods A total of 158 patients with advanced NSCLC who were admitted to Chest Hospital District of the Affiliated Brain Hospital of Nanjing Medical University from May 2010 to September 2015 were retrospectively analyzed. All patients received systemic chemotherapy plus or not local radiotherapy. The clinicopathological characteristics of patients and the results of peripheral serum protein and fibrinogen were collected, and the correlation between peripheral serum protein and fibrinogen levels and prognosis was analyzed. Results The median level of serum albumin and plasma fibrinogen was 40.8 g/L (27.6-46.9 g/L) and 3.4 g (2.4-5.2 g/L), respectively, and the median serum albumin and fibrinogen ratio (AFR) was 12.1 (6.2-17.0). The median overall survival (OS) time in the increased serum albumin group (≥40 g/L) and the decreased serum albumin group (<40 g/L) was 17.0 and 9.0 months, respectively, and the median OS time in the increased plasma fibrinogen group (≥40 g/L) and the decreased plasma fibrinogen group (<40 g/L) was 9.0 and 17.0 months, respectively. The median OS time in the increased AFR group (≥10) and decreased AFR group (<10) was 17.0 and 8.0 months, respectively, and there were significant differences between two groups (all P < 0.01). Multivariate analysis showed that serum albumin level (HR = 1.58, 95% CI 1.20-2.06, P = 0.003), plasma fibrinogen level (HR = 1.43, 95% CI 1.01-2.03, P = 0.046) and AFR (HR = 1.81, 95% CI 1.22-2.62, P = 0.001) were independent prognostic factors of OS. Conclusions In patients with advanced NSCLC, higher albumin level and/or lower fibrinogen level are associated with better clinical prognosis. Peripheral serum albumin, fibrinogen level and AFR are independent prognostic factors for advanced NSCLC. Key words: Cacinoma, non-small cell lung; Albumin; Fibrinogen; Prognosis

Studi In-Vivo Ekstrak Daun Teh Hijau (Camellia Sinensis) sebagai Alternatif anti Bakteri Eschericia Coli pada Ayam Broiler

The prevalence of colibasillosis in chicken farms in Indonesia is very high, treatment using antibiotics is experiencing resistance, so it is necessary to look for alternatives to antibacterial. The study was aimed to determine the antibacterial effect of green tea leaf extract on broiler chickens infected with Eschericia coli by looking at the score of macroscopic lesions strengthened by histopathological examination, heterophile examination, plasma protein and fibrinogen. The research used 20 day old broilers (DOC) which were randomly divided into 4 groups, group A group B, group C and group D, each consisting of 5 DOC broilers. While maintaining ND and Gumboro vaccines on schedule like maintenance in general. At the age of 21 days all broilers in each group began to be treated as controls (Group A) without infecting E. coli and were not given 0,1g/ml water extract of green tea leaves (Camillia sinensis). Group B, intratracheal-infected broilers with local strains of E.coli were 108 cells / ml according to 0,5 Mc Farland standard, and were not given green tea leaf extract. Group C, broilers infected by intratracheal with local strains of E. coli 108 cells / ml by 0,5 Mc Farland standard, and given to drink green tea leaf extract (Camillia sinensis) 0,1 g/ml and group D, broilers were given drinking green tea leaf extract (Camillia sinensis) 0,1g/ml. During the treatment all of chickens were given food and drink ad libitum. Fourteen days after infection of E.coli, 5 chickens in each group were collected to collect blood for heterophyll, total plasma protein (TPP) and fibrinogen. And then were euthanasied with Mg SO4 saturated solution intravenously injection and necropsied for gross and histpathological examination. Analysis of blood tests results were used one way of anova (SPSS version 22 program), whereas for gross and histopathological examination with descriptive analysis. The results showed that the gross examination and histopathological organs of brolier infected with E. coli without being given a green tea extract experienced airsacculitis, pericarditis, perihepatitis and peritonitis, whereas broilers infected with E. coli and given green tea extract does not indicate the presence of inflammation. Examination of heterophile counts and blood fibrinogen levels had shown a difference (P &lt;0.05), in broilers infected with E. coli and given green tea extracts had lower amounts of hetrophils and fibrinogen levels. While blood TPP levels were not significantly different (P&gt; 0.05). The conclusion can be drawn, that the study of in vivo green tea extract (Camelia sinensis) 0,1g/ml has the potential to inhibit the infection of Eschericia coli bacteria in broiler chickens.

Effectiveness and safety of 1470-nm diode laser fulguration in the management of diffuse venous malformations

BackgroundVenous malformations (VMs) are the most frequent congenital vascular malformations. Pain and deformity are the main symptoms and usually progressive in untreated patients. Current therapeutic options are surgery (frequently partial resections with an uncomfortable postoperative period), sclerotherapy (often limited because of the need for high doses and the potential subsequent toxicity), and percutaneous intralesional laser treatment. The main objective of our study was to analyze efficiency and safety of 1470-nm diode laser treatment in the management of diffuse VMs. MethodsWe included patients treated between 2012 and 2018 whose quality of life was severely impaired. Data regarding laser settings, previous and subsequent D-dimer and fibrinogen blood levels, preprocedural and postprocedural assessment of pain by means of a visual analog scale, and reported complications were collected. ResultsTwenty-six procedures were performed in 17 patients (76% women); 59% were sporadic VMs, 70% had previously undergone other treatments, and 53% needed continuous analgesic treatment. The median pain reduction after the intervention, measured on the visual analog scale, was 5 points (P < .001). A significant decrease in the postoperative D-dimer values (P = .003) was observed in all patients. There were five postoperative complications in four patients, and none was life-threatening. ConclusionsThe diode laser appears to be effective for treatment of diffuse VMs. It allows a reduction of the volume and symptoms of the malformation and is well tolerated by the patients. There is no currently described limitation in terms of dosage or number of procedures, making this a good alternative therapeutic option for these malformations.

Effect of tracheal antimicrobial peptide on the development of Mannheimia haemolytica pneumonia in cattle.

Bacterial pneumonia causes significant economic loss to the beef industry and occurs at times of stress and viral infection. Administering antibiotics to at-risk calves is often used to prevent the disease, but alternatives to mass treatment with antibiotics are needed. Tracheal antimicrobial peptide (TAP), a β-defensin naturally produced by bovine airways, has bactericidal activity against the pathogens that cause pneumonia in cattle. However, TAP expression is suppressed by glucocorticoid (stress) and viral infection. We hypothesized that delivering TAP to the respiratory tract would prevent development of pneumonia in calves infected with Mannheimia haemolytica. Clean-catch calves (i.e. obtained prior to contact with the dam) were challenged by aerosol with M. haemolytica, and TAP or water was delivered to the respiratory tract at 0.3, 2 and 6 hours post-infection. TAP treatment did not protect against development of disease. Calves treated with TAP had similar bacterial loads in the nasal cavity and lung compared to calves treated with water. Similarly, TAP treatment did not affect the development of clinical signs, elevated rectal temperatures, or increased levels of blood neutrophils, haptoglobin and fibrinogen that occurred after bacterial challenge. Postmortem gross and histologic lung lesions were also similar in the two groups. To determine why there was a lack of protective effect, we tested the effect of substances in respiratory lining fluid on the bactericidal activity of TAP. Physiologic concentrations of sodium chloride inhibited TAP bactericidal activity in vitro, as did serum at concentrations of 0.62 to 2.5%, but concentrated bronchoalveolar lavage fluid had no consistent effect. These findings suggest that TAP does not have in vivo bactericidal activity against M. haemolytica because of interference by physiological sodium chloride levels and by serum. Thus, administration of TAP may not be effective for prevention of M. haemolytica pneumonia.

Unravelling fatty liver haemorrhagic syndrome: 2. Inflammation and pathophysiology

ABSTRACT To study the role of inflammation in the pathophysiology of the fatty liver haemorrhagic syndrome (FLHS), mature laying hens were treated with oestrogen (β-oestradiol-17-dipropionate or E2) and challenged with lipopolysaccharide (LPS). Oestrogen injections induced FLHS, but the incidence and severity of the condition was increased with a combination of E2 & LPS. Hepatic mRNA levels of the genes encoding key regulators of inflammation, such as interleukin-1β (IL-1β), interleukin-6 (IL-6) and interleukin-18 (IL-18), were evaluated. The expression of IL-6 mRNA in hepatocytes of all treated groups (E2, LPS and E2 & LPS hens) was elevated from 6-fold to 56-fold (P < 0.01), when compared to baseline and control values, with the highest fold change at 3 h post-treatment. The mRNA levels for IL-1β were better expressed at 24 h post-treatments with E2, LPS and E2 & LPS. The expression of IL-18 mRNA in the liver tissue was lower than IL-1β and IL-6 mRNA in all treated birds. At 24 h post-treatment, total white blood cell (WBC) counts and fibrinogen levels were elevated (P < 0.05) in E2-, LPS- and E2- & LPS-treated hens. Histologically, livers of hens from E2- and E2- & LPS-treated groups revealed inflammatory alterations with areas showing mononuclear aggregations, vacuolar fatty degeneration of hepatocytes, and increased sinusoidal congestion and haemorrhages. It was concluded that liver lipid accumulation and injury were associated with incidences of local (hepatic) and systemic inflammation, which could have initiated liver blood vessel and capsule rupture and, subsequently, the onset of FLHS.

Correlations of degree of coronary artery stenosis with blood lipid, CRP, Hcy, GGT, SCD36 and fibrinogen levels in elderly patients with coronary heart disease.

To explore the correlations between the degree of coronary artery stenosis with blood lipid, C-reactive protein (CRP), homocysteine (Hcy), gamma-glutamyl transpeptidase (GGT), soluble cluster determinant 36 (sCD36), and fibrinogen (Fib) levels in elderly patients with coronary heart disease. The Gensini scores for the coronary artery stenosis were analyzed in patients with single-vessel, double-vessel, and multi-vessel coronary artery diseases in observation group and normal people in control group. Changes in blood lipid-associated parameters, including total cholesterol (TC), triacylglycerol (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C), CRP, Hcy, GGT, sCD36, and Fib were compared between the two groups. The correlations between the Gensini score with changes of the blood-associated parameters, CRP, Hcy, GGT, sCD36, and Fib were analyzed. Finally, univariate and multivariate logistic regression analyses were conducted to determine the risk factors for coronary artery stenosis in elderly patients with coronary heart disease. The Gensini score was significantly higher in coronary heart disease patients with multi-vessel, double-vessel, and single-vessel coronary artery diseases compared with that in normal people (p<0.05). The levels of the blood lipid-associated parameters TC, TG, and LDL-C in observation group were substantially higher than those in control group (p<0.05), and the level of HDL-C was notably lower than that in control group (p<0.05). Subjects in observation group had markedly higher levels of CRP, Hcy, GGT, sCD36, and Fib than control group (p<0.05). The Gensini score for the degree of coronary artery stenosis was positively correlated with the levels of the blood lipid-associated parameters TC and TG, CRP, Hcy, GGT, sCD36, and Fib (p<0.05) and negatively associated with the level of HDL-C (p<0.05). Blood lipid-associated parameters, CRP, Hcy, GGT, sCD36, and Fib were the independent risk factors for coronary artery stenosis in elderly patients with coronary heart disease patients. The elevations of blood lipid, CRP, Hcy, GGT, sCD36, and Fib levels are closely associated with coronary artery stenosis, and serve as the independent risk factors for coronary artery stenosis.

Clinical study of cystatin C in assessing the severity of community acquired pneumonia

Objective To explore the clinical value of cystatin C in predicting the severity of community-acquired pneumonia(CAP). Methods From January 2016 to August 2016, the clinical data of 122 patients with CAP in Shengjing Hospital of China Medical University were retrospectively analyzed.The patients were divided into low-risk group(74 cases) and middle-high risk group(48 cases) according to pneumonia severity index (PSI). The cystatin C, procalcitonin, C-reactive protein(CRP), white blood cell (WBC) count, neutrophil percentage(NE%), D-dimer and fibrinogen(FIB) levels in hospitalized patients were detected.The relationship between cystatin C and the above related indicators and the PSI was evaluated.Draw ROC curve with cystatin C and above indicators to predict severity of CAP. Results In the low-risk group, the levels of procalcitonin, CRP, WBC count, NE%, D-dimer, FIB were[0.08(0.04, 0.23)]ng/L, [42.35(12.52, 93.70)]mg/L, [7.85(6.23, 10.38)]×109/L, (66.87±13.49)%, [215.00(134.25, 410.25)]μg/L, [4.52(3.71, 5.14)]g/L, respectively, which in the middle and high risk group were [0.25(0.07, 0.54)]ng/L, [74.30(40.45, 122.75)]mg/L, [7.90(5.78, 10.63)]×109/L, (73.97±10.77)%, [417.50(239.75, 730.00)]μg/L, [4.57(3.87, 5.08)]g/L, respectively, the differences of NE%, procalcitonin, CRP, D-dimer between the two groups were statistically significant(t=3.064, U=3.024, 2.800, 3.771, all P 0.05). In the low-risk group, the level of cystatin C was[0.82(0.68, 0.91)]mmol/L, which in the middle-high risk group was[1.32(1.12, 1.54)]mmol/L, the difference between the two groups was statistically significant(U=7.978, P<0.001). When the level of cystatin C was 0.975 mmol/L, the sensitivity for the diagnosis of pneumonia severity was 95.8%, with a specificity of 85.1%. Conclusion Monitoring cystatin C levels can be used as an indicator of inflammatory response and can predict the severity of pneumonia. Key words: Cystatin c; Community-acquired infections; Procalcitonin; C-reactive protein; D-dimer; Fibrinogen; Leukocyte count; Neutrophils; Pneumonia; Severity of illness index

Prevalence of obesity and obesity-associated muscle wasting in patients on peritoneal dialysis

Background and aimsA progressive decrease in muscle mass until full-blown sarcopenia may occur in patients on peritoneal dialysis (PD) and worsen their life quality and expectancy. Here we investigate the prevalence of obesity and obesity-associated muscle wasting in PD patients. Patients and methodsThe study design was observational, cross sectional. Body composition was assessed with BIA and BIVA in 88 PD patients (53.4 ± 13.1 years; 67% male). Patients with obesity and/or with reduced muscle mass were identified using FMI and SM/BW cutoff values, respectively. Inflammatory status was assessed by measuring CRP and fibrinogen blood levels. ResultsA total of 44.3% of the patients showed a reduced muscle mass (37.5% moderate and 6.8% severe). The prevalence of obesity was 6.1%, 81.8%, and 100% in patients with normal, moderately, and severely reduced muscle mass, respectively (p < 0.05). Of the total, 15.2% of the patients with normal muscle mass, 18.4% of those with moderately reduced muscle mass, and 66.7% of those with severely reduced muscle mass had diabetes. The prevalence of severe muscle mass loss was higher in those with diabetes than in those without diabetes (22.2% vs. 2.8%, p < 0.05). Patients with obesity-associated muscle wasting showed higher fibrinogen (613.9 ± 155.1 vs. 512.9 ± 159.5 mg/dL, p < 0.05) and CPR (1.4 ± 1.3 vs. 0.6 ± 0.8 mg/dL, p < 0.05) blood concentrations than those with normal body composition. ConclusionObesity and diabetes were strongly associated with muscle mass loss in our PD patients. It remains to be established whether prevention of obesity with nutritional interventions can halt the occurrence of muscle mass loss in patients on PD.

Effect of dermatan sulphate on a C57-mouse model of pulmonary fibrosis.

ObjectiveTo test the antifibrotic effect of dermatan sulphate in a bleomycin-induced mouse model of pulmonary fibrosis.MethodsC57 mice were randomly divided into four experimental groups: saline-treated control group, bleomycin-induced fibrosis group, prednisolone acetate group and dermatan sulphate group. Lungs were assessed using the lung index, and the extent of interstitial fibrosis was graded using histopathological observation of haematoxylin & eosin-stained lung tissue. Lung tissue hydroxyproline levels and blood fibrinogen levels were measured using a hydroxyproline colorimetric kit and the Clauss fibrinogen assay, respectively. Tissue-type plasminogen activator (tPA) was measured using a chromogenic tPA assay kit.ResultsLung index values were significantly lower in the dermatan sulphate group versus the fibrosis group. Histopathological analyses revealed that dermatan sulphate treatment ameliorated the increased inflammatory cell infiltration, and attenuated the reduction in interstitial thickening, associated with bleomycin-induced fibrosis. Hydroxyproline and fibrinogen levels were decreased in the dermatan sulphate group versus the fibrosis model group. Dermatan sulphate treatment was associated with increased tPA levels versus controls and the fibrosis group.ConclusionsDamage associated with bleomycin-induced pulmonary fibrosis was alleviated by dermatan sulphate.

Highly sensitive and wide-range nanoplasmonic detection of fibrinogen using erythrocyte membrane-blanketed nanoparticles

Fibrinogen, which is a glycoprotein that circulates in the blood, plays various important biological roles, e.g., in blood coagulation, fibroblast proliferation, angiogenesis, and wound healing. Abnormal levels of fibrinogen in plasma have been identified as a key biomarker of a variety of disorders from cardiovascular diseases to hemophilia. Therefore, the development of a quantitative assay for fibrinogen in the blood has emerged as an important issue for the prevention and diagnosis of these diseases. Meanwhile, it is well known that erythrocytes can selectively capture fibrinogen because of the fibrinogen receptor expressed on their plasma membrane. Inspired by these biological interactions, herein, we devised an erythrocyte membrane (EM)-blanketed biosensor based on localized surface plasmon resonance (LSPR) for highly sensitive detection of fibrinogen. By placing the EM onto a nanoparticle-on-substrate, we enhanced the LSPR signal, achieving highly sensitive and selective detection of fibrinogen. We demonstrated that fibrinogen detection is possible over a wide concentration range, 0.001–5.000 mg/mL, which can cover normal and pathological blood fibrinogen levels. In addition, it was verified that the biosensor selectively detects fibrinogen in comparison with other human-blood-plasma components. The nanoplasmonic sensor blanketed with the EM opens up new opportunities for the development of a robust fibrinogen-sensing technology.

Serum Levels of Some Inflammatory Markers in Alloxan- Induced Diabetic Rats Treated with Aqueous Leaf Extract of Terminalia catappa and Exogenous Insulin

Background: Inflammation is said to be associated with hyperglycaemia and is implicated in the complications of diabetes.&#x0D; Aim: This study was designed to investigate the level of some inflammatory markers in blood of diabetic rats administered with aqueous leaf extract of Terminalia catappa and exogenous insulin. &#x0D; Materials and Methods: Thirty five (35) Wistar rats were assigned to 5 groups of 7 animals each. Group 1 served as the control and received 5ml/kg body weight of distilled water and group 2 received orally, 130/kg body weight of aqueous leaf extract of Terminalia catappa. Groups 3 (diabetic only), 4 (diabetic + extract) and 5 (diabetic + insulin) were administered 150 mg/kg body weight of alloxan solution intraperitoneally to induce diabetes and blood glucose levels ≥200 mg/dl after 72 hours were considered diabetic. Then 5 ml/kg bodyweight of distilled water, 130 mg/kg body weight of Terminalia catappa leaf extract was given orally and 0.75U/kg body weight of insulin was administered subcutaneously to respective groups and the experiment lasted for 14 days.&#x0D; Results: The results showed significant (P&lt; 0.05) increase in serum levels of C-reactive protein, Interleukin-6 and blood fibrinogen in diabetic group compared to control. These inflammatory biomarkers significantly (P&lt;0.05) reduced in diabetic group treated with extract and insulin. &#x0D; Conclusion: Therefore aqueous leaf extract of Terminalia catappa can reduce some inflammatory cytokines and ameliorate inflammation in diabetes similar to exogenous insulin.

Evaluation of stroke mortality and related risk factors: A single-center cohort study from Gaziantep, Turkey

Aim: In most cases diabetes worsens the outcome of acute stroke. Acute hyperglycemia, higher C-reactive protein (CRP) and fibrinogen levels predict increased risk of in-hospital mortality. However, pneumonia is found to be major causes of death after stroke. In this study we aimed to define the risk factors of mortality of ischemic stroke.Methods: This study was an analysis of retrospectively collected data of patients treated in intensive care unit (ICU) due to ischemic stroke.Results: One hundred twenty-eight patients’ files were evaluated. Mortality rate was 30.4% (n=39). The risk of stroke death was higher in presence of adverse events in ICU, presence of pneumonia findings, trans-tracheal intubation, long ICU stay, higher heart beats, lower SPO2 and pH levels, higher blood glucose and fibrinogen levels, higher CRP levels and the variation of CRP, higher APACHI-II, A2DS2 (risk of stroke) scores and lower GCS scores. Pneumonia was the most adverse event in ICU and the second most reason of the death.Conclusions: APACHI-II, A2DS2 scores and GCS scores can predict the stroke death, and preventing the pneumonia may decrease acute mortality rate of ischemic stroke. CRP together with fibrinogen levels can be used as a prognostic factor in ischemic stroke.

Comparative Effect of Aspirin, Meloxicam and Terminalia catappa Leaf Extract on Serum Levels of Some Inflammatory Markers in Alloxan Induced Diabetic Rats

Background: The association between diabetes mellitus and inflammation is established but the use of non-steroidal anti-inflammatory drugs is not without some health risk.&#x0D; Aim: The study was aimed at comparing the levels of some inflammatory biomarkers in diabetic rats treated with aqueous leaf extract of Terminalia catappa, non steroidal anti-inflammatory drugs (NSAIDs) and exogenous insulin.&#x0D; Materials and Methods: Thirty six (36) Wistar rats were assigned to 6 groups of 6 animals each. Group 1 and 2 served as normal and diabetic controls and received orally 5ml/kg body weight of distilled water. Group 3 was diabetic treated orally with 130mg/kg body weight of aqueous leaf extract of Terminalia catappa. And groups 4, 5 and 6 were administered orally with aspirin (30mg/kg), meloxicam (2mg/kg) and 0.75U/kg body weight of insulin subcutaneously. Diabetes was induced with intraperitoneal injection of 150mg/kg body weight of alloxan solution and diabetes confirmed after 72 hours with blood glucose levels ≥200mg/dl. The experiment lasted for 14 days and blood was collected by cardiac puncture for serum analysis of C-reactive protein, Interleukin-6 and Fibrinogen by ELISA method.&#x0D; Results: The results showed significant (P&lt;0.05) increase in serum levels of C-reactive protein, Interleukin-6 and blood fibrinogen in diabetic group compared to control. These inflammatory biomarker were significantly (P&lt;0.05) reduced by the extract, aspirin, meloxicam and insulin. &#x0D; Conclusion: The reduced levels of C-reactive protein, Interleukin-6 and fibrinogen by aqueous leaf extract of Terminalia catappa was significant compared to aspirin and meloxicam. This may present the extract as a potent anti-inflammatory agent and could complement the function of insulin in diabetes treatment.

Effect of Tongbi decoction on endothelial function and hemorheology in patients with coronary heart disease with angina pectoris

Objective To observe the effect of Tongbi decoctionon for the changes of the endothelial function and hemorheology in patients with coronary heart disease. Methods A total of 90 patients with angina pectoris were divided into the observation group and the control group according to the random number table method, with 45 in each group. The control group was given routine clinical treatment, and the observation group was treated with Tongbi decoction on the basis of the control group. After treated for 4 weeks, the pain severity of angina pectoris was observed before and after treatment, and the frequency and duration of angina pectoris were recorded. The levels of serum vascular endothelin (ET) and endothelin (VEGF) were measured by ELISA. The serum NO was measured by nitrate reductase method, and whole blood viscosity and plasma viscosity were measured by blood viscometer. The hematocrit was measured by hematocrit analyzer and optical density method. The erythrocyte aggregation index was measured, and the fibrinogen level was measured by heating precipitation method. And the clinical efficacy was evaluated. Results After treatment, the total effective rate was 93.3% (42/45) in the observation group and 77.8% (35/45) in the control group, and there was significant difference between the two groups (Z=-3.164, P=0.002). After treatment, the score of angina pain (0.62 ± 0.05 vs. 1.17 ± 0.14, t=5.733) , the frequency of angina attack (3.62 ± 0.43 times/week vs. 5.02 ± 0.64 times/week, t=5.042), the duration of angina attack (3.17 ± 0.42 minutes/time vs. 4.06 ± 0.51 minutes/time, t=4.781) in the observation group were significantly lower than those in the control group (P<0.05). After treatment, the levels of VEGF and NO in the observation group were significantly higher than those in the control group (t value was 5.892, 5.347, all Ps<0.05), and ET was significantly lower than that in the control group (t=4.926, P=0.037). After treatment, the whole blood viscosity, plasma viscosity, hematocrit, aggregation index and fibrinogen levels in the observation group were significantly lower than those in the control group (t values were 4.832, 4.233, 5.031, 4.136, 4.531, all Ps<0.05). Conclusions The application of Tongbi decoction can improve the endothelial function of patients with angina pectoris, adjust the hemorheological indexes and relieve the symptoms related to angina pectoris. Key words: Angina, stable; Coronary disease; Tongbi decoction; Nitroglycerin; Endothelin; Hemorheology; Erythrocyte aggregation; Fibrinogen

Are Acute Phase Reactants and CA125 Useful for Pregnancy Prediction in Frozen Embryo Transfer?

Objective: This study assessed blood C-reactive protein (CRP), fibrinogen, procalcitonin, and CA125 levels and determined whether they have an effect on pregnancy. Material & Methods: Between Feb. and Sep. 2018, 50 consecutive women who had their first frozen embryo transfer at a tertiary referral IVF center in Turkey were included in the study. Serum samples were collected on the second day of the cycle and on the transfer day. The women were divided into two groups based on the results of pregnancy outcome: pregnant (group 1) and non-pregnant (group 2). Blood CRP, fibrinogen, procalcitonin, and CA125 levels were compared between the groups. Results: There were no statistically significant differences between the groups according to CA125, CRP, fibrinogen, and procalcitonin levels at the beginning of the cycle and on the transfer day. In comparison with levels at the beginning of the cycle and on the transfer day, fibrinogen and CRP were significantly higher on the transfer day than at the beginning of the cycle. Procalcitonin was significantly higher on the transfer day than at the beginning of the cycle in group 1. However, there was no statistically significant difference between the transfer day and the beginning of the cycle in group 2. Conclusions: However, the fibrinogen, CRP and procalcitonin levels were significantly higher on the transfer day than at the beginning of the cycle. The results indicated that acute phase reactants or CA125 should not be used to determine the time of embryo transfer or predict pregnancy.

Blood fibrinogen levels discriminate low- and high risk intraductal papillary mucinous neoplasms (IPMNs)

Background: The risk assessment of intraductal papillary mucinous neoplasms (IPMN) to either guide patients to surgical resection or watchful waiting is still under debate. Additional markers to better separate low and high-risk lesions would improve patient selection. Methods: Patients who underwent pancreatic resections for IPMNs between January 2008 and December 2012 with available blood samples were selected and retrospectively assessed. Data on cyst characteristics such as cyst size, duct relation and main-duct dilatation were collected and plasma fibrinogen levels were measured. Results: A total of 73 patients fulfilled the inclusion criteria by pancreatic resection for pathologically confirmed IPMN and available blood sample. Histologically, IPMNs were classified as low-grade and borderline in 52 (71.2%, group 1) and as high-grade and invasive in 21 (28.8%, group 2) of all cases. Fibrinogen levels showed significant differences between the two groups (group 1: mean 3.62 g/L (SD ± 1.14); group 2: mean 4.49 g/L (SD ± 1.57); p= 0.027). A ROC-curve analysis calculated a cut-off value of 4.71 g/L separated groups 1 and 2 (p= 0.008). Fibrinogen levels remained as the only significant factor in multivariable analysis, cyst size and duct relation were not significant. Conclusion: Blood fibrinogen differed between low and high risk IPMNs and therefore, the use of fibrinogen as an additional discriminator in the pre-operative risk assessment of IPMNs should be further evaluated.

Коагуляционный гемостаз у крыс линии Вистар после кратковременной транзиторной ишемии головного мозга

Hemocoagulation properties in rats following a single short-term transient cerebral ischemia were studied for 21 days of the postischemic period using the coarulometric methods involving the automatic optical determination of fibrin clot formation time in the blood plasma. On the 3rd day we observed the lowered activity of the external, internal and general hemocoagulation pathways: the activated partial thromboplastin time (aPTT), prothrombin time (PT) and thrombin time (TT) were increased, indicating the hypocoagulation in the hemostatic system. These changes were accompanied by the increase of the blood fibrinogen levels, probably due to the post-ischemic inflammation. Subsequently, the fibrinogen levels were increased again on the 14th day of the post-ischemic period. That increase was accompanied by the shortening of the aPTT, indicating hypercoagulation following the internal blood clotting pathway mechanisms. At the same day, we observed the increased TT, indicating the acceleration of the fibrin clot formation in the final stage of blood coagulation. Hypercoagulative changes in the hemostasis system developing along the internal and external hemocoagulation pathways were evidenced by the shortening of the aPTT and PT in comparison with the values in the control rats on the 21st day of the post-ischemic period. Thus, the risk of secondary thrombosis persists for 2-3 weeks after a single short-term transient cerebral ischemia.

Blood fibrinogen levels discriminate low- and high risk intraductal papillary mucinous neoplasms (IPMNs)

Background: The risk assessment of intraductal papillary mucinous neoplasms (IPMN) to either guide patients to surgical resection or watchful waiting is still under debate. Additional markers to better separate low and high-risk lesions would improve patient selection. Methods: Patients who underwent pancreatic resections for IPMNs between January 2008 and December 2012 with available blood samples were selected and retrospectively assessed. Data on cyst characteristics such as cyst size, duct relation and main-duct dilatation were collected and plasma fibrinogen levels were measured. Results: A total of 73 patients fulfilled the inclusion criteria by pancreatic resection for pathologically confirmed IPMN and available blood sample. Histologically, IPMNs were classified as low-grade and borderline in 52 (71.2%, group 1) and as high-grade and invasive in 21 (28.8%, group 2) of all cases. Fibrinogen levels showed significant differences between the two groups (group 1: mean 3.62 g/L (SD ± 1.14); group 2: mean 4.49 g/L (SD ± 1.57); p= 0.027). A ROC-curve analysis calculated a cut-off value of 4.71 g/L separated groups 1 and 2 (p= 0.008). Fibrinogen levels remained as the only significant factor in multivariable analysis, cyst size and duct relation were not significant. Conclusion: Blood fibrinogen differed between low and high risk IPMNs and therefore, the use of fibrinogen as an additional discriminator in the pre-operative risk assessment of IPMNs should be further evaluated.

Systematic review on efficacy and safety of Danshen Chuanxiongqin Injection in treatment of acute cerebral infarction

To systemically evaluate the therapeutic efficacy and safety of Danshen Chuanxiongqin Injection in treatment of acute cerebral infarction and provide the reference of evidence-based medicine for its clinical safety and effective drug use. Databases including CNKI, WanFang Data, SinoMed, the Cochrane Library, EMbase and PubMed were searched from inception to April 2018 to collect the randomized controlled trials (RCTs) on Danshen Chuanxiongqin Injection in the treatment of acute cerebral infarction. The quality of all included studies was evaluated by two independent reviewers following the cochrane systematic review method and using Revman5.3 software and State13.0 for Meta-analysis. A total of 30 RCTs involving 3 233 patients with acute cerebral infarction were included in the study after literature quality evaluation. Meta-analysis showed that as compared with the control group of conventional western medicine alone, Danshen Chuanxiongqin Injection combined with conventional western medicine can achieve better efficacy in treatment of acute cerebral infarction, increase the clinical total effective rate (RR=1.22, 95% CI [1.18, 1.27], P<0.000 01) and activities of daily living (MD=9.42, 95% CI [8.12, 10.72], P<0.000 01), and improve the degree of neurological impairment (MD=-3.99, 95% CI [-4.89, -3.07], P<0.000 01). Furthermore, the result showed that Danshen Chuanxiongqin Injection in the treatment of acute cerebral infarction can significantly decrease the whole blood high-shear viscosity, whole blood low-shear viscosity, plasma viscosity, fibrinogen level and other hemorheological indexes (P<0.01). This Meta-analysis demonstrated that Danshen Chuan xiongqin injection in the treatment of acute cerebral infarction is safe and effective, but lacks the large multicenter clinical randomized trials to support the treatment outcome.

Fibrinogen for the management of critical obstetric hemorrhage.

AimIn cases of critical obstetric hemorrhage leading to extreme hypofibrinogenemia, fibrinogen is the marker that indicates the critical severity, and early fibrinogen supplementation centering on hemostatic resuscitation is a vital treatment to stabilize a catastrophic condition. In this review, we investigated the effect of fibrinogen level on hemostasis and what we can do to treat hypofibrinogenemia efficiently and improve patients’ outcome.MethodsWe reviewed numerous articles related to hypofibrinogenemia in critical obstetric hemorrhage. Especially, we performed a systematic review on target value of fibrinogen for hemostasis and effectiveness of fibrinogen concentrate. We also reviewed the articles about the methods for early normalization of fibrinogen level such as tranexamic acid, massive transfusion protocol, and point‐of‐care testing.ResultsThe target value of fibrinogen calculated by needs for massive transfusion was 200 mg/dL or 10 mm of A5FIBTEM. Although fibrinogen concentrate worked poorly on fibrinogen levels within the normal range, it improved the blood fibrinogen levels rapidly when it was administered to critical obstetric hemorrhage patients with serious hypofibrinogenemia. Hence, the volume of FFP transfused could be reduced along with a reduction in the frequency of pulmonary edema due to volume overload.ConclusionThe patient group for which fibrinogen concentrate works most effectively is cases with severe hypofibrinogenemia. Further research is required in the light of evidence. The essence of the transfusion algorithm in critical obstetric hemorrhage is to approach the target value for obtaining hemostasis, ensure an accurate and prompt grasp of the severity using point‐of‐care testing, introduce a massive transfusion protocol and use tranexamic acid.