Hemorheological Changes Research Articles

The effect of rehabilitation measures on the severity of endotoxicosis and its relationship with changes in hemorheology in acute poisoning

Introduction. The use of multidimensional statistical analysis methods (factorial and cluster methods) to study the pathogenesis and sanogenesis of acute poisoning (AP) with psychopharmacological agents (pPPhA), neurotoxicants (pNT) and corrosive substances (pCS) did not allow us to judge the presence of a direct connection between the hemorhealogy system (HR). We received a positive answer to this question earlier with the help of pair correlation analysis (PCA). New data on the sanogenetic effect of the applied methods of rehabilitation treatment in terms of changes in the indicators of HR and endotoxicosis (ET) and the relationship between them are also interesting. The purpose of the work is to assess the initial state of the indicators of HR and ET and the effect on them of a combination of medicinal and non–medicinal products used as part of rehabilitation measures for AP. Material and methods. Paired correlation analysis of the block structure of the obtained correlation matrices was applied to 52 patients with severe pPPhA, pNT and pCS. This analysis established the relationship between two indicators – both before the start of rehabilitation measures (the use of ethylmethylhydroxypyridine succinate, laser hemotherapy, hyperbaric oxygenation and mesodiencephalic modulation in accordance with the type of AP), and after their completion, before the discharge of patients from the hospital. Results. Statistically significant correlations were established between the indicators of HR and ET both before the start of treatment (0.44–0.94, without sign) and after its completion (0.49–0.99, without sign), which allowed us to confirm at a higher level a direct link between the development of HR and ET disorders, as well as to draw a conclusion about the sanogenetic effect of rehabilitation treatment. Limitations. The study has no limitations for further use of this methodological approach. Conclusion. The obtained data can serve as a justification for the introduction into practice of the proposed methods of mathematical analysis of the results of treatment measures.

ASSOCIATION OF HYSTERECTOMY WITH HYPERTENSION INCIDENCE IN KOREAN WOMEN: A NATIONWIDE COHORT STUDY

Objective: Although several observational studies have reported a higher risk of cardiovascular events in women who underwent hysterectomy, the underlying mechanism is unclear, and limited data exist regarding the effect of hysterectomy on the incidence of hypertension. We sought to evaluate the association between hysterectomy and the development of hypertension in Korean women aged 40–59 years. Design and method: In this Korean nationwide cohort study, 803,255 women aged 40-59 years were selected for analysis from January 1, 2002, to December 31, 2011. In total, 13,650 pairs were included in the hysterectomy and non-hysterectomy groups after 1:1 propensity score matching for age at 5-year intervals, year of inclusion, socioeconomic status, body mass index, residential region, Charlson comorbidity index, menarcheal age, menopause, diabetes, dyslipidemia, physical activity, smoking history, alcohol consumption, menopausal hormone therapy before inclusion, adnexal surgery history, uterine leiomyoma, and endometriosis. The primary outcome was the development of hypertension during follow-up. The participants were followed-up until December 31, 2020. Data analysis was performed from July 16, 2022 to January 07, 2023. Results: During median follow-up periods (10.6 years [IQR 9.2-12.6]; 10.9 years [IQR 9.2-12.7]), the incidence of hypertension was 22/1,000 person-years and 20/1,000 person-years for the hysterectomy and non-hysterectomy groups, respectively. The hysterectomy group had a significantly higher rate of development of hypertension than that of the non-hysterectomy group (hazard ratio [HR], 1.11; 95% confidence interval [CI], 1.05-1.17). The risk was prominent in women whose hemoglobin level increased by >2g/dL post-hysterectomy. In women who had an adnexa-sparing hysterectomy, the incidence of hypertension was higher (HR, 1.15; 95% CI 1.08-1.23, P <0.001) than that in the non-hysterectomy group. Conclusions: In this nationwide cohort study of Korean women revealed that hysterectomy was independently associated with an increased risk of hypertension among women aged 40 to 59. In particular, this risk elevation was prominent when the hemoglobin level increased by >2g/dL after hysterectomy, suggesting that hemorheologic changes following hysterectomy may have an impact on the occurrence of hypertension.

Clinical Relevance of Plasma Lactic Acid in the Onset and Prognosis of Sudden Deafness.

Sudden deafness poses a significant threat to patients' quality of life, yet effective indicators for evaluating its onset and prognosis remain elusive. The inner ear is primarily supplied by the labyrinthine artery, which lacks collateral circulation. Changes in coagulation function and hemorheology can cause spasm or thrombosis of the labyrinthine artery, leading to ischemia, hypoxia, and microcirculation disorders in the inner ear, ultimately resulting in sudden deafness. This retrospective study examined 196 patients with sudden deafness, utilizing the 2015 Chinese guideline for diagnosis and treatment classification. Coagulation system analysis used the STA-R Evolution automatic coagulation analyzer, measuring activated partial thromboplastin time (APTT), prothrombin time (PT), and fibrinogen (FIB). Plasma lactate concentration was determined using a Johnson and Johnson Fusion 5.1 model plasma lactate detector. Results of the study revealed a correlation between the degree of hearing loss and disease prognosis. Patients with higher grade hearing loss exhibited elevated plasma lactate levels upon admission compared with those with lower grade hearing loss. Importantly, elevated plasma lactate levels at admission served as predictive indicators for treatment outcomes. In addition, patients with ineffective treatment demonstrated a more coagulable blood state, as evidenced by the lower APTT (ineffective treatment: 31.47 ± 4.55 seconds, effective treatment: 35.17 ± 5.38 seconds) and PT on admission, but higher plasma FIB. In conclusion, plasma lactate levels upon admission hold promise as prognostic markers for sudden deafness treatment outcomes, providing valuable insights for clinical management.

Rationale for early rehabilitation of patients with uterine corpus cancer

To study the dynamics of hemorheologic changes and the frequency of early complications of laparoscopic radical hysterectomy in patients with uterine corpus cancer depending on conducting rehabilitation activities in the early postoperative period. The number of patients with uterine corpus cancer equal 49 (mean age 54.8±2.2 years), divided into 2 comparable groups, was examined: experimental group - 23 patients, who received local magnetotherapy since the first day after surgery for 5-6 days, and control group - 26 patients without physiotherapy. Comparative group included 24 healthy women. The basic rheological parameters, namely blood viscosity at high and low shear rate, hematocrit, erythrocytes' aggregation and deformability, erythrocytes and platelets electrophoretic mobility, were evaluated in all patients initially, on the 1st and 5th days after surgery and in comparison group. There were changes in the rheological properties of the blood before surgery in patients of both groups: increase of blood viscosity, enhancement of aggregation activity of its formed elements, decrease of erythrocytes' deformability properties. The laparoscopic radical hysterectomy was accompanied by the exacerbation of these disorders. The early magnetotherapy in patients reduced hemorheological abnormalities up to the preoperative parameters (p<0.05) for 5 days, as well as reduced the incidence of early postoperative complications by 2.4 times compared to the control group. The application of local low-frequency low-intensity magnetotherapy since the first postoperative day allows to reduce the level of postoperative hemorheological abnormalities up to the level of preoperative parameters, as well as the frequency of early postoperative complications.

Hemorheology in thyroid abnormalities: old team player, new insights

Thyroid dysfunctions significantly impact various physiological processes, extending their influence on hemorheological properties and microcirculation. This comprehensive review explores the intricate relationship between thyroid disorders and hemorheology, emphasizing the substantial effects on blood flow dynamics and tissue perfusion. Examining the alterations in blood viscosity, erythrocyte behavior, and microvascular circulation in both hypothyroidism and hyperthyroidism reveals crucial insights into the pathophysiology of these conditions. Furthermore, elucidating the hemorheological changes associated with thyroid dysfunctions offers potential avenues for improved clinical management strategies. This review synthesizes current research findings, highlighting the importance of considering hemorheological aspects in understanding the complexities of thyroid-related complications and advancing patient care paradigms.

Network pharmacology and experimental verification to explore the anti-superficial thrombophlebitis mechanism of Mailuo shutong pill

Ethnopharmacological relevanceMailuo shutong pill (MLST) has been widely used in clinical treatment of superficial thrombotic phlebitis (STP). Nevertheless, the major active components of MLST and the mechanism of synergistic action have not been reported. Aim of the studyThe present study aimed to evaluate the improving effects and the underlying mechanism of MLST on mannitol-induced STP in rabbits. Material and methodsIn this study, Ultrahigh-performance liquid chromatography electrospray ionization quadrupole-exactive orbitrap mass spectrometry (UHPLC-ESI-Q-Exactive-Orbitrap-MS) was used to analyze and identify the chemical composition of MLST and the prototype components absorbed into the blood. Then, according to the prototype components in serum, the targets and mechanisms of MLST were explored by applying network pharmacology. The rabbit model of STP was established by injecting 20% mannitol into bilateral auricular vein. The pathological changes of rabbit ear tissues, inflammatory factors, coagulation function and hemorheology were detected. In addition, molecular docking verified the interaction between the main active ingredient and the key target. Finally, the PI3K/AKT pathway and its regulated downstream pathways were verified by Western blot. ResultsA total of 96 MLST components and 53 prototypical components absorbed into the blood were successfully identified. Based on network pharmacology, PI3K/AKT pathway and 10 chemical components closely related to this pathway were obtained. Hematoxylin-eosin (HE) staining results indicated that MLST effectively improved of the pathological damage of ear tissues. MLST decreased levels of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6 and C-reactive protein (CRP). The expression of platelets (PLT) and fibrinogen concentration (FIB) was decreased, while prothrombin time (PT) and activated partial thromboplastin time (APTT) were prolonged. In addition, the plasma viscosity and whole blood viscosity in the MLST groups were significantly decreased. The more important discovery was that the expressions of P-PI3K, VEGF, P-AKT, P-IκB-α, P–NF-κB, NLRP3, ASC, Cleaved IL-1β and Cleaved Caspase-1 were effectively reversed after treatment with MLST. ConclusionsThis study comprehensively analyzed and characterized the chemical composition of MLST and the prototypical components absorbed into the blood. This study strongly confirmed the pharmacodynamic effect of MLST on STP. More importantly, this pharmacodynamic effect was achieved through inhibition of the PI3K/AKT pathway and its regulated NF-κB and NLRP3 pathways.

An in vivo investigation on the effects of stent implantation on hematological and hemorheological parameters.

Even though cardiovascular stenting is widely used for the treatment of coronary artery disease, information on how it can affect the hematological and hemorheological profile is scarce in the literature. Most of the work on this issue is based on theoretical or computational fluid dynamics models, lacking in-depth in vitro and in vivo experimental verification. This work investigates, in an in vivo setting, the effects of stenting and the implantation time-course on hematological and hemorheological parameters that could potentially compromise the device's functionality and longevity. Custom-made self-expanding nitinol stents were implanted in the common carotid artery of male CD1 mice. Whole blood samples were collected from control (non-stented) and stented animals at 5 and 10 weeks post-implantation. Hematological measurements and blood viscosity, red blood cell aggregation, and deformability were performed using standard techniques. Implant-induced changes were observed in some of the hematological and hemorheological indices. Blood viscosity seems to have been negatively affected by an increased hematocrit and reduced RBC deformability, at 10 weeks post-implantation, despite a slight decrease in RBC aggregation. Although the alterations observed may be the result of the peri-implant inflammatory response, the physiological consequences due to hemorheological changes need to be further investigated.

Hemorheological changes in arterial hypertension in persons with and without COVID-19

BACKGROUND: Vascular resistance, and therefore blood pressure (BP), depends on vascular and rheological factors. Microrheological characteristics of red blood cells (RBCs) can affect blood viscosity (BV) and thus be included in the pathogenesis of increased blood pressure in arterial hypertension (AH). Signaling molecules such as gasotransmitters (NO, CO and H2S) regulate vascular tone and RBC microrheological characteristics and thus affect blood pressure and tissue perfusion. OBJECTIVE: It was evaluated the changes in the macro- and microrheological characteristics of blood and red blood cells (RBCs) under arterial hypertension in persons with and without COVID-19, as well as the protective effect of NO and H2S donors on the RBC microrheological properties. METHODS: Hemorheological profile parameters were recorded in group 1 individuals (n = 18, 9 women and 9 men) without a history of COVID-19; group 2 (n = 16; 11 females and 5 males), hypertensive patients who had COVID-19. As a control, there was a group of healthy individuals (group 3 n = 22). In experiments with red blood cells (RBCs) and their recovered ghosts (filled with an isotonic solution of known viscosity), deformability (RBCD) and aggregation (RBCA) were recorded after incubation of cells with sodium nitroprusside (SNP, 100μM) and sodium hydrosulfide (NaHS, 100μM). RESULTS: In patients with AH in both groups, the main parameters of the hemorheological profile were negatively changed, including a decrease in RBCD and an increase in BV, plasma viscosity (PV) and RBCA. SNP and NaHS significantly increased deformability and reduced their aggregation (p &lt; 0.01). However, in healthy individuals, microrheological responses to GT donors (100μM) were more pronounced than in patients with AH, especially in the AH+COVID-19 group (p &lt; 0.05). CONCLUSION: Both gasotransmitter donors (NO and H2S) have a positive effect on the RBC microrheological characteristics in healthy and sick individuals. However in hypertensive patients, especially those who had COVID-19, microrheological responses to GT donors were significantly lower. Therefore, on the model of red cell microrheological responses, as on a test object, it is possible to determine the decrease in the sensitivity of cells and tissues to the regulatory action of gasotransmitters.

Changes in Hematological and Hemorheological Parameters Following Mild COVID-19: A 4-Month Follow-Up Study.

Coronavirus Disease 2019 (COVID-19) was described to affect red blood cells (RBC) in both severe and mild disease courses. The aim of this study was to investigate whether hematological and hemorheological changes that were previously described for COVID-19 patients after the acute infection state are still prominent after another 4 months to assess potential long-term effects. Hematological and RBC rheological parameters, including deformability and aggregation, were measured 41 days after infection in COVID-19 patients and non-COVID control (T0) and 4 months later in COVID-19 patients (T1). The data confirm alterations in hematological parameters, mainly related to cell volume and hemoglobin concentration, but also reduced deformability and increased aggregation at T0 compared to control. While RBC deformability seems to have recovered, hemoglobin-related parameters and RBC aggregation were still impaired at T1. The changes were thus more pronounced in male COVID-19 patients. COVID-19-related changes of the RBC partly consist of several months and might be related to persistent symptoms reported by many COVID-19 patients.

Inflammatory Biomarkers and Blood Physical Property Transformations Following On-Pump Coronary Artery Bypass Graft Surgery.

This study aimed to compare the hemorheological and inflammatory changes before and after coronary artery bypass graft (CABG) surgery, as factors such as hypothermia, hemodilution, transfusion, and other variables affect blood viscosity and inflammation during the procedure. A total of 25 patients who underwent CABG surgery were enrolled in this study. Whole blood was collected just before the CABG (D0), 2 days after surgery (D2), and 5 days after surgery (D5). The plasma viscosity (PV) and whole blood viscosity (WBV) were measured at shear rates ranging from 0.1 to 1000 s-1 using a rheometer, and the mean values were compared. Inflammatory markers were also assessed and analyzed in relation to the hemorheological changes. Compared with the baseline values, the PV significantly increased after 5 days. WBV showed a significant increase on day 2 and after 5 days. The WBV and fibrinogen were significantly correlated on day 2 and day 5 but not before surgery. Inflammatory markers such as CRP, WBC, platelets, and fibrinogen also demonstrated notable changes in relation to the hemorheological alterations. This study highlights the crucial finding that hyperviscosity, characterized by elevated PV and WBV, persists for almost one week after on-pump CABG surgery. Understanding the interplay between inflammation and hemorheological properties during the postoperative period is crucial for optimizing patient care. Future research should focus on exploring the underlying mechanisms and potential therapeutic interventions to mitigate the impact of inflammation on blood viscosity and improve patient outcomes following CABG surgery.

Effects of Age and Season on Blood Parameters of Captive Giant Pandas: A Pilot Study.

The giant panda, Ailuropoda melanoleuca, serves as a flagship species for biodiversity conservation, embodying the intersection of ecological, evolutionary, and anthropogenic forces shaping the natural world. Hematological parameters serve as crucial indicators for assessing the physiological status of animals. However, our understanding of blood parameters and hemorheology in captive giant pandas under non-anesthetic conditions is limited. In this study, from September 2018 to August 2020, we collected blood samples from captive giant pandas under non-anesthetic conditions. Twelve captive giant pandas, ranging in age from 2 to 28 years, were divided into three groups based on their age, and the variations in basic blood parameters and hemorheological parameters across four seasons were analyzed. This provided baseline data for future blood sample comparisons in non-anesthetized captive giant pandas. Additionally, we observed seasonal changes in hematological morphology, hemorheology, and serum enzymes. Moreover, seasonality had a regulatory effect on hemorheological parameters and negatively impacted blood viscosity. Age influenced changes in serum enzymes, serum protein content, and serum metabolites, indicating differences in overall metabolic processes among giant pandas of different age groups. Whether factors such as season and climate contribute to environmental stress in captive giant pandas requires further investigation. The findings of this study may help to protect the stability of the giant panda population better and provide a reference for the medical care of captive giant pandas.

Anterior inferior cerebellar artery occlusion accompanied by hemorheology-documented increased blood viscosity: a case report.

Anterior inferior cerebellar artery (AICA) occlusion is a subtype of posterior circulation stroke. Confirmation of its angiomorphology and etiology is challenging because of the complex mechanisms underlying small-artery thrombogenesis. In addition to conventional factors, physicians frequently overlook hemorheological changes. In this case report, we describe right AICA occlusion in a 50-year-old man. He presented with an unsteady walk, tinnitus, dizziness, and left-sided peripheral facial palsy observed over 36 hours, accompanied by increased blood viscosity on hemorheological evaluation. Magnetic resonance imaging revealed acute infarction in the left cerebellar hemisphere and middle cerebellar peduncles. Magnetic resonance angiography (MRA) and computed tomographic angiography (CTA) failed to detect AICA occlusion, which was later confirmed using digital subtraction angiography. Repeat routine blood examinations showed elevated erythrocyte and leukocyte counts and serum hemoglobin concentrations that persisted over many days. Hemorheological evaluation revealed increased whole blood viscosity at a low shear rate. AICA occlusion should thus be diagnosed based on its initial characteristic manifestations; notably, MRA and CTA may fail to detect arterial occlusion. The importance of hemorheological change as a factor of stroke is frequently neglected. We therefore report this case hoping to emphasize its relevance, especially in small-artery occlusion.

Microcirculatory and Rheological Adaptive Mechanisms at High Altitude in European Lowlander Hikers and Nepalese Highlanders.

Physical activity at high-altitudes is increasingly widespread, both for tourist trekking and for the growing tendency to carry out sports and training activities at high-altitudes. Acute exposure to this hypobaric-hypoxic condition induces several complex adaptive mechanisms involving the cardiovascular, respiratory and endocrine systems. A lack of these adaptive mechanisms in microcirculation may cause the onset of symptoms of acute mountain sickness, a frequent disturbance after acute exposure at high altitudes. The aim of our study was to evaluate the microcirculatory adaptive mechanisms at different altitudes, from 1350 to 5050 m a.s.l., during a scientific expedition in the Himalayas. The main haematological parameters, blood viscosity and erythrocyte deformability were assessed at different altitudes on eight European lowlanders and on a group of eleven Nepalese highlanders. The microcirculation network was evaluated in vivo by conjunctival and periungual biomicroscopy. Europeans showed a progressive and significant reduction of blood filterability and an increase of whole blood viscosity which correlate with the increase of altitude (p < 0.02). In the Nepalese highlanders, haemorheological changes were already present at their residence altitude, 3400 m a.s.l. (p < 0.001 vs. Europeans). With the increase in altitude, a massive interstitial oedema appeared in all participants, associated with erythrocyte aggregation phenomena and slowing of the flow rate in the microcirculation. High altitude causes important and significant microcirculatory adaptations. These changes in microcirculation induced by hypobaric-hypoxic conditions should be considered when planning training and physical activity at altitude.

COVID-19-Induced Changes in Photoplethysmography.

Photoplethysmography (PPG) is the science behind many commonly used medical devices such as the pulse oximeter. PPG changes, herein as "PPG dropouts," have been described in existing in vitro studies following artificially induced clot activation. Because COVID-19 causes increased arterial, venous, and microvascular clot formation, our hypothesis is that PPG dropouts identified in vitro can also be found in vivo in patients with COVID-19. The aim of this study is to evaluate PPG recordings and D-dimer levels for patients hospitalized with COVID-19 and compare them with the PPG tracings from non-COVID controls. PPG recordings were obtained for 197 ICU patients with COVID-19 and 300 non-COVID controls. PPG tracings were obtained using a TigerTech CovidPlus monitor, which received U.S. FDA emergency use authorization in March 2020 for monitoring the biometrics of patients with COVID-19 and featured unfiltered red and infrared spectrum PPG monitoring. D-dimer lab results were also recorded whenever available. The results demonstrated significant differences in the prevalence rate of PPG dropout among patients with COVID-19 vs. non-COVID controls. The median PPG dropout rate was 0.58 for COVID-19 patients (median 0.58, IQR 0.42-0.72, P < .05) as opposed to a median 0.0 for non-COVID patients (median 0.0, IQR 0.0-0.0, P < .05). Furthermore, at least one incidence of PPG dropout was detected in 100% of COVID-19 patients, as opposed to 2.3% of non-COVID controls (P < .05). PPG dropout also correlated closely with the normalized serum D-dimer levels taken on the same day. The change in the normalized D-dimer levels was plotted against the change in PPG dropout, and a line of best fit was created. Linear regression resulted in R2 = 0.743 (P < .05), indicating that changes in the PPG dropout rate correlate with hemorheological changes in COVID-19 patients. PPG dropout, like D-dimer, may not be specific for COVID-19. However, the inflammatory nature of the disease and the prevalence of prolonged ICU created a large sample size and allowed the authors to observe PPG changes in vivo in a statistically meaningful way. Further confirmatory studies are needed to confirm the potential application of PPG dropout as a measure of inflammation in other disease processes.

Established UPLC-MS/MS procedure for multicomponent quantitative analysis of rat plasma: Pharmacokinetics of Taohong Siwu Decoction in normal and acute blood stasis models

Ethnopharmacological relevanceAs one of China's 100 classic recipes, Taohong Siwu Decoction (THSWD) consists of Siwu Tang flavored peach kernel and safflower, and is used to nourish and activate blood. Accordingly, THSWD is mainly administered to treat blood deficiency and stasis syndrome. According to prior studies, THSWD induces antioxidant stress, inhibits inflammatory reactions, inhibits platelet aggregation, prevents fibrosis, reduces blood lipids, prolongs clotting time, prevents atherosclerosis and vascular pathology, improves hemorheological changes, and regulates related signaling pathways. Materials and methodsA sensitive analytical method was developed to detect the marker components of THSWD using UPLC-Q-TOF-MS. A rapid and sensitive UPLC-MS/MS analytical method was developed and applied to detect 16 major bioactive components in normal and acute blood stasis (ABS) rats following oral administration of THSWD. The metabolic process of THSWD in vivo was evaluated and the differences in pharmacokinetic parameters between the normal and ABS rat metabolic processes were compared. ResultsThis method was fully validated based on its excellent linearity (r2 < 0.99), satisfactory intra- and inter-day precisions (RSD <15%), and good accuracy (RE within ±14.83%). The stability, matrix effects, and extraction recoveries of the rat plasma samples were also within the acceptable limits (RSD <15%). Compared to normal rats, the pharmacokinetics of the major active constituents (except Senkyunolide G) were significantly different (P < 0.05) in the ABS model rats, indicating that the metabolism of the 16 compounds in vivo may change under disease conditions. ConclusionsIn this study, a sensitive UPLC-Q-TOF-MS method was established to analyze the main components of THSWD, and a UPLC-MS/MS analytical method was developed and applied for the pharmacokinetic parameter detection of the 16 main bioactive components in normal and ABS rats. Our findings lay the foundation for further studies on the pharmacokinetic-pharmacodynamic correlation for THSWD.

RED BLOOD CELL DEFORMABILITY AND PHYSICAL ACTIVITY

Physical exertion and sport cause changes of different nature and degree (positive or negative, strong, weak, moderate) in blood and blood cells’ biomechanical and fluid properties. The aim of this minireview was to attempt to summarize the main red blood cell deformability alterations during and after physical activity classified as follows: erythrocyte geometric shape; erythrocyte membrane rheological properties; biochemical and structural properties of erythrocyte membrane lipids and proteins; hemoglobin concentration; calcium ion concentration; intracellular diffusion and osmosis; nitric oxide and erythrocyte nitric oxide synthase; erythrocyte ATP synthase; erythrocyte age and degree of erythrocyte cell maturation; body and erythrocyte temperature. It is essential to study and evaluate the individual hemorheological response profile of erythrocyte deformability during physical activity because it is strongly personal. This is one of the major erythrocyte properties determining oxygen supply to working muscles. The multiple hemorheological changes during physical activity and their interconnectedness and strong personality make their differentiation very difficult. It is reasonable to weigh their effects (with specific quantitative measurements) to simplify the analysis and increase the likelihood of obtaining valid conclusions. But there will always be the probabilistic nature of these conclusions, determined by the complex and strictly individual picture of the hemorheological effects of physical exercises and activities.

Hemorheological Alterations and Physical Activity

Elucidating the complex processes that determine the ability of the human body to adapt to specific intense training programs is critical to improving athletic performance in elite athletes. The present work aims to describe the main hemorheological changes as a result of physical exercises of different intensity, frequency, duration and modes of loading. Sport and physical exertion induce a hemorheological response of different nature and degree, structured in the present paper as follows: erythrocyte aggregation; change in the concentration of basic plasma components; changes in blood flow; changes in blood volume; changes in the endothelial cells of the vascular walls; changes in blood pressure; changes resulting from tissue hypoxia; interacting, different in nature hemorheological consequences. The studied and described original models of hemorheological response can contribute to a more successful adaptation of the training programs—In order to improve the health status of the participants and to optimize the sports form of the elite athletes. Physical loads of different frequencies, intensities and durations induce a different hemorheological response in athletes. The effect of “regular, moderate and properly dosed physical activity” during training is also strictly individual. This fact suggests approaching the training regime of each elite athlete personally, practicing specific to his preparation, well-chosen, balanced physical exercises. This will help to achieve the so-called state of hemorheological fitness. Extensive future research is needed to elucidate the cellular, tissue and molecular mechanism of hemorheological changes in blood, blood cells, and blood plasma. It is essential to study the vascular characteristics and biomechanical properties of blood under physical loads with different regimes and variable parameters, taking into account the individual, professional, biological and mechanical profile of each athlete.

Сomprehensive assessment of macro- and microcirculation parameters in patients with type 2 diabetes mellitus and subclinical stage of diabetic peripheral neuropathy during treatment with antihypoxic drug

The leading cause of systemic vascular complications in diabetes mellitus (DM) is partial damage to the vascular wall and hemorheological changes in the lumen of blood vessels against the background of chronic hyperglycemia. Vasoconstriction, edema, ischemia and tissue hypoxia develop as a result of these processes, which, in addition to increasing the risk of cardiovascular diseases, lead to impaired endoneural circulation. The use of a drug with an antihypoxant effect as a pathogenetic therapy in patients with type 2 diabetes mellitus (T2DM) and a subclinical stage of diabetic peripheral neuropathy (DPN1) makes it possible to slow down the progression of micro- and macrovascular complications, along with achieving sustainable compensation for diabetes.Aim. To assess the effect of a drug with antihypoxic effects (Actovegin®) on the parameters of macro- and microcirculation of the capillary bed, arterial stiffness and endothelial function in patients with T2DM and DPN1.Material and methods. A comparative study of macro- and microcirculation parameters, arterial stiffness and endothelial function in patients with T2DM and DPN1 before and after treatment with Actovegin® (group “A”, n = 20), and a group of patients with T2DM and DPN1 without Actovegin® treatment (group “B”, n = 20).Results. An improvement in the parameters of microcirculation was revealed: expansion of the arterial section of the capillaries during treatment with Actovegin®. In patients with reduced endothelial function during treatment with Actovegin®, there is a significant increase in its function, as well as a decrease in perivascular edema. Treatment with Actovegin® does not affect the indicators of central hemodynamics and indicators of arterial stiffness in patients with T2DM and DPN1.Conclusion. The results of the study clearly demonstrated that the use of a drug with an antihypoxic effect (Actovegin®) in patients with T2DM and DPN1 significantly improves the parameters of microcirculation, and, therefore, can be recommended as pathogenetic therapy at the earliest stages of diabetes development. Integral assessment of microcirculation parameters, as well as a new technology for determining the pulse wave velocity and endothelial function allows to identify patients in need of more intensive monitoring. Conducting this examination before the start of drug therapy can serve as a guideline in assessing the effectiveness of the treatment.

Clinical Efficacy of Xueshuantong plus Urokinase in the Treatment of Sudden Deafness.

Objective To investigate the clinical effect of Xueshuantong combined with urokinase in the treatment of sudden deafness. Methods A total of 90 patients with sudden deafness who were treated in South China Hospital affiliated to Shenzhen University from June 2019 to August 2020 were recruited and assigned (1 : 1) into the control group (n = 45, urokinase) and the experimental group (n = 45, Xueshuantong plus urokinase) according to the different treatment methods. The clinical treatment effect, the degree of tinnitus, the average auditory valve of the damaged frequency, and the changes in hemorheology (plasma viscosity, whole blood high-shear reduced viscosity, whole blood low-shear reduced viscosity, hematocrit, and fibrinogen) were compared between the two groups of patients. Results The treatment with urokinase and Xueshuangtong injection in the experimental group resulted in a significantly higher clinical treatment effect when compared with the treatment in the control group (P < 0.05). After treatment, the degree of tinnitus and the average auditory valve of the damaged frequency in the experimental group were significantly lower than those in the control group (P < 0.05). The levels of hemorheology (plasma viscosity, whole blood high-shear reduced viscosity, whole blood low-shear reduced viscosity, hematocrit, and fibrinogen) in the experimental group after treatment were significantly lower than those in the control group (P < 0.05). Conclusion The clinical effect of Xueshuantong combined with urokinase in the treatment of patients with sudden deafness is remarkable, and it can effectively improve the hearing level and hemorheology-related indexes of patients, and it thus merits clinical application.

Estradiol Valerate Affects Hematological and Hemorheological Parameters in Rats.

Polycystic ovary syndrome (PCOS) is one of the most common endocrinological diseases in women. Although the risk of cardiovascular diseases is high in PCOS, the number of scientific publications describing hemorheological changes is not significant. We aimed to perform a comprehensive hematological and micro-rheological study on experimentally induced PCOS in rats.Wistar rats were divided into control (n = 9) and PCOS groups (n = 9), in which animals received single-dose estradiol valerate. Measurements were carried out before treatment and monthly for four months. Bodyweight, blood glucose concentration, hematological parameters, red blood cell (RBC) deformability, and aggregation were measured. A histological examination of the ovary was performed at the end of the experiment. The blood glucose level and the bodyweight were significantly elevated vs. base in the PCOS group. A significant decrease was seen in RBC count, hemoglobin, and hematocrit. The maximal elongation index showed a significant increase. PCOS also resulted in a significant increase in RBC aggregation index parameters. The histological and hormone examinations confirmed developed PCOS. The administration of estradiol valerate caused significant changes during the examined period in hematological and hemorheological parameters. Our results draw attention to the possible usefulness of micro-rheological investigations in further studies on PCOS.