Molecular Weight Heparin Sodium Research Articles

Therapeutic Effect of Nitroglycerin in Conjunction with Low Molecular Weight Heparin Sodium in Managing Angina Pectoris in Coronary Heart Disease

Therapeutic Effect of Nitroglycerin in Conjunction with Low Molecular Weight Heparin Sodium in Managing Angina Pectoris in Coronary Heart Disease

Chitosan‐Low Molecular Weight Heparin Sodium Nanoparticles Regulate Treg/Th17 Immune Balance and Inflammation at the Maternal‐Fetal Interface to Ameliorate Pre‐Eclampsia by HB‐EGF

AbstractPre‐eclampsia is a major cause of maternal and fetal mortality. Low molecular weight heparin sodium (LMWH) reduced the incidence of pre‐eclampsia, may be an effective treatment of pre‐eclampsia. But the underlying mechanism of LMWH is unknown. To improve the molecular utilization rate, chitosan‐LMWH nanoparticles (CHsN) are purchased for the study. The prague of pregnancy Sprague‐Dawley rats are injected with nitroso l‐arginine methyl ester to construct a pre‐eclampsia model. Trichotrophoblast cells HTR‐8/SVneo are cultured under Hypoxia/reoxygenation injury (H/R) simulation conditions to construct the cell model. CHsN ameliorates the integrity of fetal membrane tissue. Administration of CHsN results in decreased urine protein and HB‐EGF levels, accompanied by increased numbers of pups and placenta. Treatment with CHsN increases the proportion of Treg cells and decreases the proportion of Th17 cells. After treatment with CHsN, the levels of LPS, TNF‐α, rank1, slp1, Foxo, NF‐κB, and HIF‐1α are down‐regulated, while the levels of IL‐2, Foxp3, and TGFβ1 are up‐regulated. CRM197 reverses the effect of CHsN. The CHsN improves H/R‐induced HTR‐8/SVneo cells apoptosis through HB‐EGF and affected CD4+T cell differentiation. CHsN ameliorates pre‐eclampsia by regulating Treg/Th17 immune balance and inflammation at the maternal‐fetal interface through HB‐EGF. This provides a theoretical reference for relieving pre‐eclampsia by CHsN.

A Clinical Study of Low Molecular Weight Heparin Sodium Injection Combined with Magnesium Sulfate Injection and Labetalol Tablets in the Treatment of Severe Pregnancy-Induced Hypertension

Objective: To investigate the clinical effect of low molecular weight heparin sodium injection combined with magnesium sulfate injection and labetalol in the treatment of severe pregnancy-induced hypertension. Methods: A total of 48 patients with severe pregnancy-induced hypertension admitted from February 2021 to February 2023 were selected, and the patients were divided into two groups by simple sampling, with 24 cases in each group. Patients in the control group received labetalol orally and intravenous infusion of magnesium sulfate, whereas those in the observation group received subcutaneous injection of low molecular weight heparin sodium on the basis of the control group. The two groups of patients underwent 5 days of treatment, and the blood pressure control, vascular endothelial function, renal function, and blood coagulation were compared between the two groups. Results: Before treatment, there were no significant differences in blood pressure readings, endothelin-1 (ET-1) and nitric oxide (NO) levels, serum creatinine (SCr) and blood urea nitrogen (BUN) levels, and the four coagulation indices between the two groups (all P > 0.05). After treatment, the blood pressure readings in the observation group were lower than those in the control group (P < 0.05); ET-1 in the observation group was lower than that in the control group, and the NO level in the observation group was higher than that in the control group (P < 0.05); compared with the control group, the observation group had lower SCr and BUN (P < 0.05), longer prothrombin time (PT), activated partial thromboplastin time (APTT), and thrombin time (TT), and lower fibrinogen (Fib) level (P < 0.05). Conclusion: Low molecular weight heparin sodium injection combined with magnesium sulfate injection and labetalol in the treatment of severe pregnancy-induced hypertension can help control blood pressure levels, promote the recovery of vascular endothelial function and renal function, and effectively correct coagulation function.

Application of Quality Control Circle Activities in Reducing the Incidence of Adverse Reactions to Subcutaneous Injection of Low Molecular Weight Heparin Sodium

Application of Quality Control Circle Activities in Reducing the Incidence of Adverse Reactions to Subcutaneous Injection of Low Molecular Weight Heparin Sodium

Experience of treating batches of exertional heat stroke patients in military training

To explore the process and segments of intense treatment of patients suffered from exertional heat stroke (EHS), and to provide the experience and guidance for treating batches of EHS patients. A retrospective study of the curing process of eight EHS patients admitted to the Eighth Medical Center of Chinese PLA General Hospital on May 18th, 2019 was conducted, including onsite treatment and subsequent transshipment to hospital for treatment. Based on the medical history with high-intensity exercise and the clinical manifestation of central nervous system dysfunction, the eight patients were quickly diagnosed as EHS on the site, and were immediately rehydrated and attained the systematic cooling. An emergency plan for the treatment of batches of patients was initiated instantly for quick medical evacuation and care, and the patients were quickly transferred to the Eighth Medical Center of Chinese PLA General Hospital. A therapeutic principle was strictly followed, concerning the transshipment accompanied by systematic cooling while the medical evacuation and care, therapeutic preparation and immediate opening of the green channel were started up in the hospital. Sticking to the plan of allocating patients vs. nurses vs. doctor by 1:3:1, enough persons were dispatched. Ventilators, hemofiltration machines and ice blanket machines were prepared. Through the professional diagnosis and treatment in the emergency department, the patients were transferred to the ICU department. The relevant medical departments were coordinated with the centralization of the ICU department. The vital signs of patients were monitored closely. The titration and precise treatment were implemented, based on the changes in blood routine examination, blood biochemical indexes, blood clotting function, and blood gas analysis. The continuous renal replacement therapy (CRRT) was performed for four patients, the ice blanket machine cooling therapy for two patients, and the tracheal intubation and mechanical ventilation for one patient. Low molecular weight heparin sodium anticoagulant treatment was used in one patient with the diffuse intravascular coagulation (DIC) on the basis of coagulation factors such as plasmas and fibrinogens supplementation. The function of the damaged organs was significantly improved in 5-11 days. Eight patients were finally transferred out from ICU department. All patients were recovered and discharged after 11-20 days. A normative treatment process (rapid recognition on the site, rapid cooling, rapid and safe medical evacuation, in-hospital multidisciplinary collaboration) combined bundles of therapeutic strategy such as systematic cooling and rehydration, CRRT, and supplying the coagulation factors while anticoagulation treatment can provide a strong guarantee for rescuing batches of EHS patients and achieve satisfactory treatment outcomes.

A real-world study of low molecular weight heparin sodium in the treatment of severe and critical bite by Trimeresurus stejnegeri

To investigate the clinical effect of low molecular weight heparin sodium combined with antivenin in the treatment of severe and critical bite by Trimeresurus stejnegeri. The clinical data of 48 patients with severe or critical bite by Trimeresurus stejnegeri admitted to emergency department of Southeast Hospital Affiliated to Xiamen University from March 2017 to May 2019 were retrospectively analyzed. On the basis of early treatment of antivenom serum, internal administration and external application of Jidesheng snake tablet, and wound incision and detoxification, the patients were divided into heparin treatment group and non-heparin treatment group according to whether the low molecular heparin sodium was used or not. The patients in the two groups were compared in terms of gender, age, clinical classification, swelling degree of injured limbs, change of coagulation function index, bleeding of skin, mucous membrane or digestive tract, blood transfusion, local symptoms of bite, length of hospital stay and prognosis. There was no significant difference in terms of gender, age, clinical classification or swelling degree of injured limbs between the two groups. On the 3rd day of treatment, the platelet count (PLT) in the heparin treatment group was significantly higher than that in the non-heparin treatment group [×109/L: 210.0 (160.0, 252.0) vs. 136.0 (104.0, 198.5), P < 0.05]. However, there was no significant difference in the four coagulation test results between the two groups. On the 6th day of treatment, the plasma thrombin time (TT) in the heparin treatment group was significantly shorter than that on the 3rd day of treatment [s: 30.3 (20.4, 37.0) vs. 34.7 (24.0, 73.4), P < 0.05], and the fibrinogen (FIB) in the heparin treatment group was significantly higher than that in the non-heparin treatment group [g/L: 0.60 (0.31, 1.07) vs. 0.20 (0.14, 0.60), P < 0.01]. The incidence of bleeding in the heparin treatment group was significantly lower than that in the non-heparin treatment group [21.7% (5/23) vs. 64.0% (16/25), P < 0.01]; 11 patients in the heparin treatment group and 18 patients in the non-heparin treatment group received blood transfusion and prothrombin complex supplement respectively. There was no significant difference in the length of hospital stay between the heparin group and non-heparin treatment group (days: 6.91±1.92 vs. 7.48±2.27, P > 0.05). The patients in both groups were followed up for 1 week to 1 month after treatment, and no death or local necrosis of skin and soft tissue was found. For the patients with severe and critical bite by Trimeresurus stejnegeri, on the basis of injection of antivenom serum, internal administration and external application of Jidesheng snake tablet, and wound incision and detoxification, early application of low molecular weight heparin sodium anticoagulation and other comprehensive treatment is helpful to improve limb swelling and inflammation, reduce blood transfusion, promote the recovery of coagulation function, and shorten the length of hospitalization.

Preserving hip treatment of steroid-induced osteonecrosis of the femoral head

Objective To investigate the early diagnosis and treatment options for steroid-induced osteonecrosis of the femoral head (SONFH). Methods Retrospective analysis was conducted in 73 patients with unilateral SONFH from January 2010 to June 2017. There were 27 males and 46 females, aged 34.26±10.35 years (range, 20-45 years). The following type of cases were included, 21 cases of ARCO I, 24 cases of IIa, 8 cases of IIb, 18 cases of IIc and 2 cases of IIIa. Patients with ARCO I were limited in weight and were treated with low molecular weight heparin sodium and ginkgo dharma drugs after excluding bleeding risk. Core decompression was performed in patients with ARCO IIa and IIb vascularized greater trochanter bone transfer was conducted in patients with IIc and IIIa. During the follow-up duration, when the ARCO I progressed to ARCO IIa and IIb, the core decompression was performed. When the ARCO IIa and IIb progressed to the ARCO IIc or IIIa, the vascularized greater trochanter bone transfer was conducted. Vascularized greater trochanter bone combined with the tantalum rod was implanted in ARCO IIIb. The femoral head reconstruction with the larger trochanter bone flap or joint replacement was performed in ARCO IIIc and above. The Harris hip score was used to evaluate the clinical outcomes. The femoral head survival curve of SONFH was drawn with the end of joint replacement. Results All 73 patients were followed up for an average of 29 months (range, 18 to 48 months). After treatment of 21 patients with ARCO I, a total of 14 (67%) patients had no ARCO staging progress. After 6 months, three patients progressed to ARCO IIb and 4 patients progressed to ARCO IIc. All 32 patients with ARCO IIa and IIb were treated, of which 25 (78%) did not progress but 4 patients progressed to ARCO IIIa at 6 months. Only one patient progressed to ARCO IIIb at 6 months, and 2 patient progressed to ARCO IIIc at 12 months. There were 18 patients with ARCO IIc underwent treatment, of which 14 patients (78%) did not progress but 2 patients progressed to ARCO IIIa at 6 months and 2 patients progressed to ARCO IIIc at 24 months and to ARCO IV at 42 months, respectively. Two patients of ARCO IIIa, 1 patient did not progress and the other one progressed to ARCO IV at 36 months. The Harris hip score was 90.48±5.36 before treatment and 91.76±8.19 at the last follow-up. The difference was not statistically significant (t=1.231, P=0.402). The Harris hip score of patients with ARCO IIa and IIb in creased from 75.22±8.30 to 84.47±16.77 with statistically significant difference (t=5.624, P<0.001). The Harris hip score of patients with ARCO IIc and IIIa increased from 59.80±9.24 to 77.75±20.75 with statistically significant difference (t=12.033, P<0.001). Four patients eventually underwent arthroplasty. The femoral head survival rate was 98.6% at 2 years and 94.5% at 4 years. Conclusion The SONFH can be diagnosed early by screening, and is treated by different reserving hip methods according to severe stages. The short-term clinical effects are satisfied. Key words: Glucocorticoids; Femur head necrosis; Free tissue flaps; Decompression, surgical

Clinical Effect of Low Molecular Weight Heparin Sodium Combined with Magnesium Sulfate in the Treatment of Patients with Severe Preeclampsia.

To investigate the effect of low molecular weight heparin sodium combined with magnesium sulfate in the treatment of patients with severe preeclampsia. An experimental study. The Department of Obstetrics and Gynecology, The Affiliated Hospital, North China University of Science and Technology, from April 2016 to July 2017. Patients with severe preeclampsia were randomly divided into observation group (52 cases) and control group (51 cases). In the control group, magnesium sulfate were used, but in observation group low molecular weight heparin sodium were added. After treatment of 7 days, serum TGF-β1, VCAM-1, ES levels and endothelial function markers of NO and ET-1 changes were compared between the two groups.The delivery status after treatment was observed in both groups. After treatment of 7 days, serum TGF-β1 and NO levels in the observation group were higher than those in control group (both p<0.001), and VCAM-1, ES, ET-1, ET-1/NO levels in observation group were lower than those in control group (all p<0.001). Among the patients who delivered live births, observation group had a longer delivery gestation age after treatment than that of control group (p=0.038); placental quality, body mass and 1 minute Apgar score of surviving newborns in observation group were all higher than those in control group (all p<0.001). Low molecular weight heparin sodium combined with magnesium sulfate may improve the.

Application value of continuous blood purification in pediatric intensive care unit: analysis of 203 cases

To explore the clinical application value of the continuous blood purification (CBP) technology in pediatric intensive care unit (ICU). A retrospective study was conducted. All CBP patients admitted to pediatric ICU of Children's Hospital of Nanjing Medical University from 2015 to 2017 were enrolled. The disease diagnosis, CBP treatment mode, catheter placement, anticoagulation way, treatment time and adverse reactions were summarized and analyzed. (1) A total of 203 children were included, male accounted for 59.1%; age 37 days to 14 years old, with an average of (4.52±3.60) years old; weight 3.3-68.0 kg, with an average of (21.38±13.77) kg. (2) There were a total of 660 CBP treatments, with an average of 3.25 times per person. The main treatment modes of CBP were plasma exchange (PE, 38.64%), and followed by continuous veno-venous hemodiafiltration (CVVHDF, 38.64%), hemoperfusion (HP, 16.51%) and continuous veno-venous hemofiltration (CVVH, 6.21%). (3) Central venous catheterization was mainly placed in the right internal jugular vein (90.64%), followed by the right femoral vein (5.42%) and the left femoral vein (3.94%). (4) Heparin sodium was the main anticoagulant in pipeline filters (84.73%), followed by low molecular weight heparin calcium (11.33%), sodium citrate and non-anticoagulant (both 1.97%). Mixed anticoagulants were used 21 children. (5) Primary diseases included poisoning (26.11%), liver failure (25.62%), sepsis (12.32%), shock after cardiopulmonary resuscitation (11.82%), acute respiratory distress syndrome (ARDS, 8.37%), central nervous system diseases (5.41%) and metabolic diseases (4.93%). The lowest efficacy of CBP was metabolic diseases, with mortality rate of 60.00%; followed by ARDS, shock after cardiopulmonary resuscitation, sepsis and liver failure, with mortality was 58.82%, 41.67%, 36.00% and 32.69%, respectively. The length of hospitalization stay of children with central nervous system diseases was (30.89±15.13) days. (6) Adverse events of CBP treatment included uncontrollable restlessness (2.88%), hypotension (1.82%), allergic rash (1.21%), catheterization and pipeline coagulation (1.21%), filter coagulation (1.06%), decreased heart rate and oxygen saturation (0.76%); CBP was stopped in 8 children due to cardiac arrest during the treatment. At present, the application of CBP technology in pediatric ICU is universal, and it is an important way to rescue critical illness.

Successful Treatment for End—Stage Hepatic Alveolar Echinococcosis With ex vivo Liver Resection and Autologous Liver Transplantation: A Case Report

3045_A.tif Figure 1: Preoperative 3D imaging analysis system revealed the retro—hepatic IVC was involved (arrow)3045_B.tif Figure 2: The irregular outflow of right/short hepatic vein reconstruction (A: great saphenous veins; B—C: right/short hepatic vein reconstruction using the great saphenous veins wall)Objective To explore the surgical process of ex—vivo liver resection and autologous liver transplantation (ERAT) for end—stage hepatic alveolar echinococcosis (HAE) and evaluate the therapeutic effect and surgical benefit. Methods The clinical data of one end—stage HAE patient treated with ERAT combined complicated hepatic vein reconstructionwas analyzed retrospectively. Preoperative examination and intraoperative exploration revealed the second hepatic portal was involved. We successfully initiated an operation through ex—vivoliver resection, hepatic vein reconstruction with the autogenous saphenous vein, and subsequent piggyback autologous liver transplantation by wide—mouth hepatic vein—artificial inferior vena cava anastomosis (end to side). Results This patient discharged uneventfully 14 days after the operation. The injection of low—molecular—weight heparin sodium and consequent oral warfarin sodium tablets were administered for anticoagulant therapy. Regular autograft ultrasound examination revealed no tarombokinesis in autologous liver and inferior vena cava. Conclusion ERAT is an ideal surgical method for end—stage HAE. Wide—mouth hepatic vein reconstruction using an autogenous saphenous vein is the key procedure. Postoperative anticoagulant therapy is significant for the improvement of transplanted liver function.3045_C.tif Figure 3: Piggyback autologous liver transplantation (A—C)

Investigation and analysis of hemodialysis blood tubing vein pot particle formation and related factors

Objective To investigate the composition of particulate matter in hemodialysis and to explore the influencing factors of particulate matter formation. Methods The composition of the particles was determined by chemical experiments and electron microscopy. Fifty-four outpatients in hemodialysis centers were divided into pellets and non - particulate groups (34 and 20 cases). Thirty-four variables were collected by literature review and their influencing factors were analyzed. Results The particles were white thrombus, formed by aggregated platelets and fibrin aggregates, and embedded in a small amount of red blood cells. Logistic regression analysis showed that low molecular weight heparin was statistically significant (OR = 1.001, P <0.01). In addition, male, smoking, dry weight, hypersensitive C-reactive protein, venous pressure, dialysate temperature, blood vessel thrombosis and granule formation were statistically significant (P < 0.05). Conclusions To improve the degree of attention to white thrombosis, the injection of low molecular weight heparin sodium into the machine before the vascular access intravenous injection, for the analysis of the results to take appropriate care measures to reduce the production of white thrombosis is important, and can be white thrombosis. The repeated formation is seen as a sign of blood vessel thrombosis Key words: Hemodialysis; Particulate matter; Intravenous pot; White thrombus; Scanning electron microscope

Maintenance of stemness is associated with the interation of LRP6 and heparin-binding protein CCN2 autocrined by hepatocellular carcinoma

BackgroundThe overall response rate of hepatocellular carcinoma (HCC) to chemotherapy is poor. In our previous study, oxaliplatin-resistant HCC is found to exhibit an enhanced stemness, and increased levels of CCN2 and LRP6, while the role of CCN2 and LRP6 in the prognosis of HCC patients, and the interaction regulation mechanism between CCN2 and LRP6 are still unclear. MethodsThe expression levels of CCN2 and LRP6 were detected in large cohorts of HCCs, and functional analyses of CCN2 and LRP6 were performed both in vitro and in vivo. The roles of cell surface heparin sulfate proteoglycans (HSPGs) in the mutual regulatory between CCN2 and LRP6 were verified in HCC, and the interventions of low molecular weight heparin sodium (LMWH) were explored. ResultsCCN2 and LRP6 were overexpressed in HCCs, and the CCN2 and LRP6 levels were positively associated with the malignant phenotypes and poor prognosis of HCCs. LRP6 could significantly upregulate the expression of CCN2. Meanwhile, CCN2 was able to enhance malignant phenotype of HCC cells in a dose-dependent manner through binding with LRP6; and knock-down of LRP6 expression, perturbation of HSPGs, co-incubation of CCN2 with LMWH could significantly block the adhesion of CCN2 to LRP6. LMWH enhanced the therapeutic effect of oxaliplatin on HCC with a high CCN2 expression. Conclusions CCN2 plays a promoting role in HCC progression through activating LRP6 in a HSPGs-dependent manner. Heparin in combination with chemotherapy has a synergic effect and could be a treatment choice for HCCs with a high CCN2 expression.

Is injection of low molecular weight heparin sodium in different time alter outcome of vet prevention after arthroscopic partial meniscectomy?

Is injection of low molecular weight heparin sodium in different time alter outcome of vet prevention after arthroscopic partial meniscectomy?

The combined application of low molecular dextran, papaverine and low molecular weight heparin sodium to improve testicle survival rate after the reduction of testicular torsion in rabbits

Objective To observe the effect of drug combinations on the blood flow after reduction of the testicular torsion in rabbits. Methods From October 2014 to June 2015, 36 male rabbits(weighing 1.8-2.4 kg, 10-14 months of age) were randomly divided into experimental group and control group, 18 in each group.Produced by surgical testicular torsion model (720°counterclockwise rotation of the left side testicle), every rabbit was accepted surgery reset after 9 hours and found all twisted testicles were dark.After fomentation with warm salt water, all the testicles were observed no significant improvement in colors, and no fresh blood flow after opening tunica albuginea, then all the testicles were retained and fixed.Low molecular dextran(5 ml/kg, ear marginal vein injection, 1/d), papaverine(1.5 mg/kg, intramuscular, 3/d) and low molecular weight heparin sodium(200 IU/kg, subcutaneous, 1/d) were applied to promote testicular revascularization for 5 days in experimental group, and penicillin (40 000 U/kg, intramuscular, 1/d) for 7 days.Control group was only given penicillin(40 000 U/kg, intramuscular, 1/d) to prevent wound infection.Then Color Doppler ultrasound was used to observe the testicular blood flow siganals that were divided into 0, 1, 2, 3 classes.Class 2 and class 3 could be considered as testicular survival.After each scrotum was opened, according to color, texture of testicle and whether the fresh blood flowing out when tunica albuginea was opened, to determine whether the testicle was alive.The testicle was ruddy, flexible, and fresh blood was observed, which could prove testicular survival. Results In experimental group, the testicular blood flow siganals: 0 class 4 cases, 1 class 3 cases, 2 class 4 cases, 3 class 7 cases.In control group, the testicular blood flow siganals: 0 class 9 cases, 1 class 2 cases, 2 class 4 cases, 3 class 3 cases.Surgical exploration found 11 cases of testicular survival in experimental group and 7 cases in control group, which was significantly difference (P<0.05). Conclusions The combined application of low molecular dextran, papaverine, low molecular weight heparin sodium can promote the recovery of testicular blood after reduction of testicular torsion, and improve testicular survival rate. Key words: Testicular torsion; Low molecular dextran; Papaverine; Low molecular weight heparin sodium; Testicular survival

LHD-Modified Mechanism-Based Liposome Coencapsulation of Mitoxantrone and Prednisolone Using Novel Lipid Bilayer Fusion for Tissue-Specific Colocalization and Synergistic Antitumor Effects.

Coencapsulation liposomes are of interest to researchers because they maximize the synergistic effect of loaded drugs. A combination regimen of mitoxantrone (MTO) and prednisolone (PLP) has been ideal for tumor therapy. MTO and PLP offer synergistic antitumor effects confirmed by several experiments in this research. The deduced synergistic mechanism is regulation of Akt signaling pathway including the targets of p-Akt, p-GSK-3β, p-s6 ribosomal protein, and p-AMPK by MTO reactivating PLP-induced apoptosis. The liposome fusion method is adopted to create coencapsulation liposomes (PLP-MTO-YM). Low molecular weight heparin-sodium deoxycholate conjugate (LHD) then is used as a targeting ligand to prove target binding and inhibition of angiogenesis. LHD-modified liposomes (PLP-MTO-HM) have a high entrapment efficiency around 95% for both MTO and PLP. DSC results indicate that both drugs interacted with liposomes to prevent drug leak during liposome fusion. DiD-C6-HM dyes colocalize well to tumor tissue, and coadministration of DiD-HM and C6-CM did not achieve dye colocalization until 24 h after administration. In both CT26 and B16F10 mouse model, PLP-MTO-HM shows a significantly higher tumor inhibition rate relative to the coadministration of MTO-HM and PLP-CM (p < 0.05 or p < 0.01). Thus, the coencapsulation system (PLP-MTO-HM) offers ideal antitumor effects relative to coadministration therapy due to enhanced synergistic effect, and this suggests a promising future for the tumor targeting vectors.

Clinical study of low molecular weight heparin combined isoproterenol inhalation in treatment of children with severe bronchial pneumonia

Objective To explore clinical efficacy of low molecular weight heparin combined isoproterenol inhalation in treatment of children with severe bronchial pneumonia. Methods 110 patients from Jan 2013 to Apr 2014 were collected and randomly divided into treatment group (57 cases)and control group(53 cases), control group was given anti infection, hormone, expectorant, oxygen and other symptomatic treatment, besides, inhaled with isoprenaline, bid, based on which treatment group was inhalaled with low molecular weight heparin sodium injection, qd, arterial blood gas indexes were compared between 2 groups after 72 h treatment, and clinical efficacy were compared after 5 d treatment. Results After 72 h treatment, two groups of children with pulmonary function, arterial blood gas index and airway inflammatory improved obviously; treatment group with PaO2 and PaO2/FiO2 were significantly higher than control group, while PaCO2, CRP were significantly lower than control group, the differences of all above indexes were statistically significant (P 0.05). During inhalation, two groups with incidences of temporary heart rate rise (10.5% vs.13.2)had no significant difference (χ2=0.189 P=0.663 ). Conclusion Based on conventional treatment for children with severe pneumonia, low molecular weight heparin combined with isoproterenol inhalation can improve pulmonary ventilation function, reduce airway inflammation, and improve clinical efficacy to a certain extent. Key words: Bronchial pneumonia; Low molecular weight heparin; Isoproterenol; Inhalation; Pulmonary function

Comparison of the effect of low molecular weight heparin sodium and that of heparin sodium on pre-disseminated intravascular coagulation stage in patients suffering from exertional heat stroke

To study the effect of low molecular weight heparin sodium ( LMWHS ) therapy for exertional heat stroke ( EHS ) patients with pre-disseminated intravascular coagulation ( pre-DIC ). A prospective randomized controlled trial ( RCT ) was conducted. Thirty-six patients with EHS with pre-DIC admitted to Department of Critical Care Medicine of 180th Hospital of Chinese PLA from April 2012 to November 2014 were divided into heparin sodium group ( n = 20 ) and LMWHS group ( n = 16 ) in accordance with the random number table. All patients received bundle treatment after being admitted to the hospital, including rapid cooling, fluid resuscitation, organ support ( mechanical ventilation, hemopurification if necessary ), supplement of pro-coagulation factors, etc. The patients in heparin sodium group were treated with continuous heparin sodium 12 500 U throughout 24 hours with intravenous pump for 5 days, and the patients in LMWHS group were given LMWHS 2 500 U subcutaneously, twice a day for 5 days.The incidence of DIC, incidence of bleeding and mortality of two groups were compared.The platelet count ( PLT ), prothrombin time ( PT ), activated partial thromboplastin time ( APTT ), fibrinogen ( Fib ) and D-dimer of each patient between pre and post treatment times were compared. No significant difference was found in the incidence of DIC and mortality between LMWHS group and heparin sodium group ( 31.2% vs. 30.0%, χ (2) = 0.007, P = 0.936; 6.2% vs. 5.0%, χ (2) = 0.026, P = 0.871 ). Incidence of bleeding during treatment in LMWHS group was significantly lower than that in heparin sodium group ( 12.5% vs. 45.0%,χ (2) = 4.425, P = 0.035 ). After treatment, PLT in both LMWHS group and heparin sodium group was significantly increased compared with that before treatment ( ×10(9)/L: 140.5±17.5 vs. 110.5±16.5, 152.6±21.5 vs. 120.0±20.0, both P < 0.05 ) and D-dimer was significantly decreased ( mg/L: 0.5±0.1 vs. 3.2±1.2, 0.6±0.2 vs. 4.4±1.8, both P < 0.05 ). APTT after treatment in heparin sodium group was significantly prolonged compared with that before treatment ( s: 75.3±10.6 vs. 44.1±8.2, P < 0.05 ) while no change in APTT was found in LMWHS group ( s: 38.6±5.5 vs. 42.1±8.4, P > 0.05 ). No significant difference was found in PT and Fib between pre and post treatment in all the patients. When LMWHS was applied in EHS patients in pre-DIC stage, it could not only prevent DIC as efficiently as heparin sodium, but also results in lower incidence of bleeding. So LMWHS is safer.

The functional study of antithrombin L99 mutation

To study the molecular mechanisms of inherited antithrombin (AT) deficiency caused by AT L99 mutation. Wild type (WT), L99V, L99A, L99I and L99S AT were purified from drosophila expression system. The binding capacity of AT and the low molecular weight heparin sodium was analyzed by the heparin binding assay. Surface plasmon resonance (SPR) was used to detect the binding ability of AT to thrombin (FIIa) or AT to coagulation factor Xa (FXa). The activity of AT(AT∶A)was detected by chromogenic assay. The purified WT and mutant AT were at the same size. No additional band was observed by coomassie blue staining and western blot assay. Compared to the WT AT, the binding abilities of the low molecular weight heparin sodium to the AT L99V, L99A, L99I and L99S were (44.8±3.6)%, (118.9±14.0)%, (15.2±8.8)%, and(23.0±8.2)%, respectively. The binding abilities of FIIa to AT L99V, L99A, L99I and L99S were 13%, 57%, 3%, and 29%, while the binding of FXa to AT L99V, L99A, L99I and L99S were 7%, 51%, 1%, and 25%. The AT∶A of WT, L99V, L99A, L99I and L99S AT were 146.5%, 21.4%, 120.9%, 10.8%, and 39.0%, respectively. The binding abilities of AT to heparin, FIIa and FXa were damaged by the L99 mutation, which resulted in decreased AT∶A and inherited AT deficiency.

DIAGNÓSTICO CLÍNICO Y MANEJO DE LA TROMBOSIS VENOSA CEREBRAL. PRESENTACIÓN DE UN CASO CLÍNICO.

Thrombosis of the dural sinus and/or cerebral veins (CVT) is an uncommon form of stroke, usually affecting young individuals. Affects approximately 5 people per million annually and accounts for 0.5% to 1% of all strokes. We describe the case of a male patient aged 31 with no medical history known, who consulted in the emergency department holocraneal headache and generalized tonic-clonic movements, underwent brain computed tomography and arteriography of 4 vessels, discarding arteriovenous malformations and / or brain aneurysms. Angioresonance requested that reveals images of defect suggestive of superior sagittal sinus thrombosis, so anticoagulation is indicated with Low Molecular Weight Heparin and Warfarin Sodium, obtaining a favorable outcome. Regarding this case, a review of the literature with special emphasis on diagnosis, risk factors and therapeutic controversies.

E0330 One case of severe tirofiban-induced thrombocytopaenia after the emergency PCI

e0330 One case of severe tirofiban-induced thrombocytopaenia after the emergency PCI