Significant Difference In Platelet Research Articles

IMPACT OF GESTATIONAL DIABETES MELLITUS ON HEMATOLOGICAL PARAMETERS, LIVER FUNCTION, RENAL FUNCTION, AND LIPID PROFILE IN ANTENATAL WOMEN AT A TERTIARY CARE HOSPITAL

Objective: Gestational diabetes mellitus (GDM) is a condition in which glucose intolerance is first recognized during pregnancy. It affects a substantial percentage of pregnancies globally, with a significant prevalence in India. Iron supplementation is often recommended to prevent anemia, but caution is advised in GDM due to the potential inflammatory effects. Elevated hemoglobin (Hb) levels, associated with excess iron, may increase the risk of GDM. This study aims to investigate the differences in Hb and various other blood parameters between controlled and uncontrolled GDM mothers attending antenatal OPD for a regular check-up. Methods: This cross-sectional study was conducted among 100 women diagnosed with GDM at a tertiary care hospital in Western Tamil Nadu after obtaining ethical clearance and informed consent from the participants. Routine blood investigations, like a complete hemogram, HbA1C, renal and liver function tests, and lipid profiles, were recorded. Participants were categorized based on HbA1C values (<6.5 as normal, >6.5 as abnormal). Differences in blood parameters between the two groups were statistically analyzed. Results: The study found no significant differences in age, weight, height, or BMI between the controlled and uncontrolled GDM groups. Mean HbA1c levels were 5.58±0.41 and 6.98±1.23 in controlled and uncontrolled GDM groups, respectively. Comparing hematological parameters, the controlled GDM group exhibited higher mean red blood cell (RBC) levels (4.6±0.69 vs. 4.12±0.92) but lower Hb levels (12.25±2.26 vs. 11.01±3.59) than the uncontrolled GDM group. There were no significant differences in platelet, lymphocyte, and MCH levels. Urea, triglycerides, and globulin levels were higher in the uncontrolled GDM group, but all values remained within normal limits. Conclusion: Elevated Hb levels were associated with uncontrolled GDM, indicating a potential risk factor. The study underscores the importance of monitoring iron levels in GDM patients. In addition, heightened white blood cell counts and altered hematological parameters suggest an inflammatory component in uncontrolled GDM. Further research is warranted to explore these associations and their clinical implications for managing GDM effectively.

Exercise therapy against platelet levels in obesity

The purpose of this study was to determine the effect of Moderate Intensity Training (MIT) and High Intensity Interval Training (HIIT) on the number of platelets used as a treatment option for obesity. Materials and methods. This research is a true experimental laboratory study with a post test only control group design. Using 21 obese male Wistar rats with a distribution of 7 Wistar HIIT groups, 7 Wistar MIT, and 7 control Wistar groups. The exercise intervention consisted of HIIT intensity (90-100% of baseline ability), MIT intensity (60-80% of baseline ability), and control without training for six weeks. A special mouse treadmill is used for exercise. Platelet measurement by enzyme-linked immunosorbent assay (ELISA). Hematology tests are used to determine platelets. Data analysis used the Anova test. Results. There was a significant difference in platelets between the control, MIT and HIIT groups (p = 0.015). The mean value of platelets in MIT and HIIT was higher than the control group. HIIT vs Control there was no significant difference (p = 0.816) and MIT vs Control there was a significant difference (p = 0.017). Likewise HIIT vs MIT there is no significant difference (P = 0.058). Conclusion. Exercise with HIIT and MIT for 6 weeks can be used as an alternative to overcome obesity because it can reduce weight in obesity and is accompanied by an increase in platelets.

Influencing factors of anthracycline-induced subclinical cardiotoxicity in acute leukemia patients

BackgroundCurrent treatment of acute leukemia is based on anthracycline chemotherapy. Anthracyclines, despite improving patient survival, have serious cardiotoxicity and therefore cardiac monitoring should be a priority. The purpose of this study is to explore the possible early predictors of anthracycline-induced subclinical cardiotoxicity(AISC)in acute leukemia patients.MethodsWe conducted a prospective observational study involving 51 patients with acute leukemia treated with anthracycline. Demographic data, clinical variables, echocardiography variables and biochemical variables were collected at baseline and after 3 cycles of chemotherapy. Patients were divided into the AISC and No-AISC groups according to changes of global longitudinal peak systolic strain. Regression models and receiver operating characteristic curve analysis were used to explore the relationship between the variables and AISC.Result17 of the patients suffered subclinical cardiotoxicity after 3 cycles of anthracycline treatment. Multiple logistic regression analysis showed a significant association of DBil (OR 0.612, 95% CI 0.409–0.916, p = 0.017), TBil (OR 0.841, 95% CI 0.717–0.986, p = 0.033), PLT (OR 1.012, 95% CI 1.002–1.021, p = 0.016) and Glu (OR 1.873, 95% CI 1.009–3.475, p = 0.047) with the development of AISC. After 3 cycles of chemotherapy, there was a significant difference in PLT between the AISC and NO-AISC groups. Moreover, the dynamic changes in PLT from baseline to after 3 cycles of chemotherapy were each statistically significant in the AISC and NO-AISC groups. The combination of PLT and N-terminal pro–B-type natriuretic peptide (NT-proBNP) had the highest area under curves (AUC) for the diagnosis of AISC than PLT and NT-proBNP alone (AUC = 0.713, 95%CI: 0.56–0.87, P = 0.017).ConclusionTotal bilirubin (TBil), direct bilirubin (DBil), platelets (PLT) and blood glucose (Glu) are independent influencing factors for AISC in acute leukemia patients receiving anthracycline therapy. Bilirubin may be a protective factor and PLT may be a contributing factor for AISC. The combination of baseline PLT and baseline NT-proBNP shows satisfactory predictive ability for AISC in acute leukemia cases treated with 3 cycles of chemotherapy.

Analysis of the Incidence of Lower Limb Deep Venous Thrombosis and Its Related Risk Factors in the Postoperative Patients with Lung Cancer

Lung cancer is the first leading cause of morbidity and mortality among the malignant tumors, which has become a hot issue in current research. Clinically, lung cancer is divided into small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) according to the pathological types. NSCLC includes adenocarcinoma, squamous cell carcinoma and other types of lung cancer, accounting for about 80% of all lung cancer. Venous thromboembolism (VTE) includes deep venous thrombosis (DVT) and pulmonary embolism (PE), which is a recognized complication in lung cancer patients with higher morbidity and mortality. The aim of this study is to determine the incidence of DVT and reveal the risk factors for DVT in the postoperative patients with lung cancer. We collected 83 postoperative patients with lung cancer admitted to the Department of Lung Cancer Surgery, Tianjin Medical University General Hospital from December 2021 to December 2022. All these patients were examined by color Doppler ultrasound of lower extremity vein upon admission and after operation to analyze the incidence of DVT. In order to explore the possible risk factors for DVT in these patients, we further analyzed the correlations between DVT and their clinical features. At the same time, the changes of coagulation function and platelet were monitored to investigate the value of blood coagulation in the patients with DVT. DVT occurred in 25 patients after lung cancer operation, and the incidence rate of DVT was 30.1%. Further analysis found that the incidences of postoperative lower limb DVT were higher in lung cancer patients of stage III+IV or over 60 years of age (P=0.031, P=0.028). D-Dimer level in patients with thrombosis was significantly higher than that in non-thrombus patients on the 1st, the 3rd, and the 5th day after operation (P<0.05), and there was no significant difference in platelets and fibrinogen (FIB) (P>0.05). The overall incidence of DVT in our center after lung cancer patients operation was 30.1%. Late-stage and older postpatients were more likely to develop DVT, and these patients with higher D-Dimer values should be considered the possibility of VTE events.

Utility of Different Scoring Systems for the Diagnosis of Thrombotic Microangiopathies.

To investigate the appropriateness of Bentley and plasmic scores and ADAMTS-13 activity to distinguish between primary thrombotic microangiopathies (TMA) syndromes and other thrombotic microangiopathies, as well as primary thrombotic microangiopathies (TTP, complement-related TMA, etc). Descriptive study. Place and Duration of the Study: Department of Hematology, Faculty of Medicine, from February 2013 to February 2020. Data of patients with non-immune hemolytic anaemia (MAHA) and thrombocytopenia who had ADAMTS-13 test, were analysed. Clinical and laboratory findings, Bentley and plasmic scores, and ADAMTS activity levels were compared. The patients were grouped as primary (n = 27) and secondary (n = 28) TMA, the age was median 38.0 (18-63) years in the primary TMA group and 49.5 (20-84) years in the secondary TMA group. Neurological findings were less in the secondary TMA group (p = 0.008). Plasmic score, lactate dehydrogenase, and total and indirect bilirubin levels were high and D-dimer levels were low in the primary TMA group. In the primary TMA group, a greater number of patients with high plasmic scores were found, whereas all patients in the secondary TMA group had low risk according to Bentley score. Calcium levels were high and platelet levels were low in those with ADAMTS activity level <10% (p = 0.006). The evaluation of primary TMAs demonstrated significant differences in platelet, urea, creatinine, and sodium values between the two groups. Laboratory data and clinical scores are valuable in differentiating primary and other TMA. Bentley score, Complement, Plasmic score, Thrombotic microangiopathy, Thrombotic thrombocytopenic purpura, ADAMTS-13.

Neutrophil/lymphocyte, platelet/lymphocyte, monocyte/lymphocyte ratios and systemic immune-inflammation index in patients with depression.

Evidence suggest immunity abnormalities and inflammation might play an important role in the pathophysiology of depression. This study explored the relationship between inflammation and depression using neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) as inflammatory markers. We collected the full blood count results of 239 patients with depression and 241 healthy controls. Patients were divided into three diagnostic subtype groups: severe depressive disorder with psychotic symptoms, severe depressive disorder without psychotic symptoms, and moderate depressive disorder. We analyzed the Participants' neutrophil (NEU), lymphocyte (LYM), monocyte (MON), and platelet (PLT) counts, compared the differences in NLR, MLR, PLR and SII, and explored the relationships between depression and these indicators. There were significant differences in PLT, MON, NEU, MLR, and SII among the four groups. MON and MLR were significantly higher in three groups of depressive disorders. SII was significantly increased in two severe depressive disorder groups, while the SII in the moderate depressive disorder group showed an increasing trend. Increased MON, MLR and SII, as signs of inflammatory response, were not different among three subtypes of depressive disorders, and may be biological indictors of depressive disorders (Tab. 1, Ref. 17). Text in PDF www.elis.sk Keywords: depression, neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII).

Serum 25-hydroxyvitamin D expression and its correlation in patients with vestibular neuritis

Objective:To investigate the expression level of serum 25-（OH） D and its correlation in patients with vestibular neuritis（VN）. Methods:30 acute VN patients and 50 age-and sex-matched healthy controls who attended the Otolaryngology, Head and Neck Surgery Department of the First Hospital of Shanxi Medical University from October 2020 to October 2021 were selected. The demographic and clinical data of all subjects were recorded, the levels of serum 25-（OH） D and inflammatory markers were measured and compared, and the changes of serum 25-（OH） D levels in convalescent patients with VN were followed up. Results:The serum level of 25-（OH） D in the acute phase VN group was significantly lower than that in healthy controls[（10.14±2.92） ng/mL vs （20.61±4.70） ng/mL, P<0.01], and the deficiency rate of 100.0%（30/30） was significantly higher than 54.0%（27/50）. Moreover, the serum level of 25-（OH） D in the recovery period（3 months later） was significantly higher[（10.14±2.92） ng/mL vs （15.94±4.88） ng/mL, P<0.01], and the deficiency rate was significantly decreased by 76.7%（23/30）. However, the serum 25-（OH） D level was significantly lower in both the VN group than that in both the acute period and the recovery group, and the deficiency rate was significantly higher than that in the control group. Multivariate binary Logistic regression model analysis showed that low-level serum 25-（OH） D was associated with the onset of VN, with an OR value of 0.193（95%CI=0.043-0.861, P=0.031）. In addition, the results of this study showed that peripheral blood leukocyte（WBC） and neutrophil / lymphocyte ratio（NLR） levels in the acute VN group were significantly higher than in healthy controls[（7.65±3.02） ×10⁸/L vs （5.50±2.50） ×10⁸/L, P<0.01; （2.46±2.95） ×100% vs（1.67±0.92） ×100%, P<0.01 ], and there was no significant difference in Platelet / lymphocyte ratio（PLR） and and average platelet volume（MPV） levels in the two groups（P>0.05）. There were no significant differences in age distribution, sex ratio, body mass index, persistent health problems, or lifestyle groups（P>0.05）. Conclusion:This study is the first to detect serum 25-（OH） D level and inflammation index level, and dynamically assess the serum 25-（OH） D level in different stages, found that low serum 25-（OH） D is associated with the onset of VN, physiological concentration of serum 25-（OH） D is a protective factor of VN, vitamin D supplementation therapy may be a new target of VN treatment.

Quality Analysis of Autologous Platelet-Rich Plasmapheresis.

To summarized the technology of autologous platelet-rich plasmapheresis and analyzed the product quality, in order to provide safe and effective product guarantee service for clinical treatment. Technical parameters were set according to patient age, weight, height, and preoperative routine blood indices. Autologous platelet-rich plasma (PRP) was collected, and the product quality and adverse reactions of patients were statistically analyzed. Autologous PRP had platelet (PLT), white blood cell (WBC), and red blood cell (RBC) counts of (1250.26 ± 435.88) × 109/L, (1.19 ± 1.95) × 109/L, and (0.05 ± 0.04) × 1012/L, respectively. The PLT enrichment ratio in PRP was 5.66 ± 1.66. There was no significant difference in PLT, RBC, WBC, or hematocrit before and after apheresis (P > 0.05). The incidence of adverse reactions was 8%, and all were mild. When clinical patients use PRP in the treatment of diseases, autologous platelet-rich plasmapheresis technology was used to apheresis PRP, which has good product quality and few adverse reactions, and thus can be adopted more widely.

Effect of Eradication Helicobacter Pylori on Platelet Counts in Hepatitis C Infected Patients

Abstract Background Hepatitis C virus and H.pylori are the world's leading etiologies of bacterial and viral human diseases. Egypt has the world's largest prevalence of HCV, which was estimated to be 14.7 percent nationally. Objective To detect the effect of H. pylori eradication on the platelet counts in hepatitis C virus (HCV)-related CLD patients. Patients and Methods This prospective study was conducted at the Gastroenterology clinic, Internal Medicine department at Ain shams university and El-menofya hospital during the period of September 2017 to June 2018. 30 subjects were included in the study. All of them were chronic HCV infected patients (confirmed by HCV Ab and PCR for HCV) associated with thrombocytopenia (less than 100,000/μ) and were found to be H. pylori-positive (Confirmed active H.pylori infection by positive stool antigen test). Results Our results showed that there was highly statistically significant difference in platelets count with a pre-treatment range of 48-98 with mean±SD 82.40±14.16 and a post-treatment range of 50-123 with mean±SD 96.17±19.27 (10^3/cmm) Conclusion Eradication of Helicobacter Pylori leads to significant improvement of platelet counts in hepatitis C infected patients with thrombocytopenia.

Comparative analysis of some radiosensitivity index results of certain radiation workers in Chongqing from 2018 to 2019

Objective This paper analyzes the physical examination results of blood routine, chromosome deformity rate, micronucleus rate and thyroid function test of some radiation workers in Chongqing from 2018 to 2019, understands the occupational problems of radiation workers, and provide scientific basis for putting forward reasonable suggestions method: Methods 2 656 cases in 2018 and 2 922 cases in 2019 were selected through the information platform of physical examination system. A total of 5 578 physical examination results in two years were statistically analyzed and analyzed. Results The abnormal rate of blood routine, the detection rate and abnormal rate of chromosome distortion and micronucleus, and the abnormal rate of thyroid gland function (T3, T4, TSH) between the control group and the radiation group are significant differences ( P < 0.05). There were significant differences in the abnormal rate of blood routine, thyroid function (T3, T4, TSH), chromosome teratosis rate, micronucleus detection rate and abnormal rate between radiation diagnosis and treatment and industrial flaw detection, but there was no significant difference in the abnormal rate of chromosome ( P > 0.05). There was significant difference between < 10 year group and 10~20 year group, and there was significant difference in platelet, white blood cell and hemoglobin between 10~20 year group and 20 year group ( P < 0.05). There was no statistical significance in erythrocyte difference ( P > 0.05). There was significant difference in the abnormal rate of thyroid function among the three working age segments ( P < 0.05). The detection rate of chromosome distortion was significantly different between < 10 years group and 10~20 year group ( P < 0.05), but there was no significant difference between the other two groups ( P > 0.05). There was significant difference in the abnormal rate between the two groups ( P < 0.05). There was no significant difference in pairwise comparison of micronucleus detection rate among groups ( P > 0.05), but there was significant difference in abnormal rate among groups ( P < 0.05). Conclusion The long-term low dose ionizing radiation environment will damage the hematopoietic and endocrine system of radiation sensitive human body. 摘要： 目的 分析 2018—2019 年重庆市部分放射工作人员血常规、染色体畸变率、微核率、甲状腺功能试验体检结 果, 了解放射工作人员的职业健康问题, 为提出合理的建议提供科学依据。 方法 通过体检系统导出 2018 年 2 656 份, 2019 年 2 922 份, 共计 5 578 份体检结果进行统计与分析。 结果 对照组、放射组 4 项血常规异常率、染色体畸变 和微核检出率和异常率、甲状腺功能 (T3、T4、TSH) 异常率差异具有统计学意义 ( P < 0.05); 放射诊疗和工业探伤四项 血常规异常率、甲状腺功能 (T3、T4、TSH) 异常率、染色体畸变检出率、微核检出率和异常率差异具有统计学意义 ( P < 0.05), 染色体异常率无统计学意义 ( P > 0.05); <10 年组和 10~20 年组差异有统计学意义, 10~20 年组和 ≥20 年组血小板、白细胞、血红蛋白差异有统计学意义 ( P < 0.05), 红细胞差异无统计学意义 ( P > 0.05); 甲状腺功能 3 个工龄段异常率差异有统计学意义 ( P < 0.05), 染色体畸变检出率两两比较 <10 与另两组有统计学意义 ( P < 0.05), 10~20 与 ≥20 差异无统计学意义 ( P > 0.05), 异常率两两比较差异有统计学意义 ( P < 0.05); 微核检出率两两比较差 异无统计学意义 ( P > 0.05), 异常率差异有统计学意义 ( P < 0.05)。 结论 长期低剂量电离辐射环境会对射线敏感的人 体造血系统、内分泌系统造成一定损伤。

Analysis of survival rates and prognosis of hepatoblastoma in children: a retrospective study from a single center in China

Hepatoblastoma (HB) is the most common liver cancer in children, this study aims at analyzing the prognostic factors affecting the survival rates and summarizing the treatment experience. In this study, we reviewed patients with primary HB under the age of 14 years who underwent complete tumor resection from June 1997 to March 2019. The data of 72 patients were collected. Survival analysis was performed by Kaplan-Meier, multivariate Cox proportional hazards regression and linear mixed model for repeated measures (LMMRM). The 5-year and the 10-year event-free survival (EFS) of all patients were 78.2% and 73%, respectively. Both the 5-year and 10-year overall survival (OS) were 85.7%. Kaplan-Meier survival analysis showed that patients with tumor capsule infiltration (TCI) and patients with surgical margin less than 1 cm may also have a good prognosis. The Cox proportional hazards regression model analysis results were similar to the Kaplan-Meier analysis results. LMMRM analysis showed that there were significant differences in platelet, alpha-fetoprotein, C-reactive protein and hemoglobin values after surgery in the metastasis group (P < 0.05). This study suggests that patients with TCI or narrow surgical margin (<1 cm) may also have a good prognosis, and the risk stratification of HB can be used as the latest grading standard to evaluate the prognosis of patients.

The Efficacy and Toxicity of Neoadjuvant Chemotherapy Regimens of Epirubicin Plus Cyclophosphamide Followed by Docetaxel or Paclitaxel in Female Breast Cancer Patients

PurposeTo retrospectively analyze the efficacy and toxicity of epirubicin plus cyclophosphamide followed by docetaxel (EC-D) and epirubicin plus cyclophosphamide followed by paclitaxel (EC-P) efficacy as neoadjuvant chemotherapy regiments by pathological complete response (pCR) in this study.MethodsIn total, 455 patients diagnosed with breast cancer who received NAC from January 2014 to January 2019 were enrolled. Of which, 109 patients received EC-D (E: 90, C: 600, D: 80, all in mg/m2) and 346 were treated with EC-P (E: 90, C: 600, D: 175, all in mg/m2). Efficacy of NAC regimens was evaluated by pCR, and the toxicity was studied. Chi-squared test was used at p=0.05.ResultsIn EC-D, 11 patients received ypT0/isN0, and 6 of them got ypT0N0. Analogously, 67 patients receiving received EC-P obtained ypT0/isN0, and 43 people of them acquired ypT0N0. The rate of pCR in EC-P was higher than EC-D. Patients with ER (-), PR (-), Her-2 (+) and high Ki-67 index were easier to were more likely to acquire pCR. Two pCRs were described, the pCR of NAC differed according to the definition. In terms of side effects, there was no significant difference in platelet and urea, but the decrease of hemoglobin and creatinine levels after EC-P treatment was more significant than that after EC-D treatment.ConclusionThe efficacy of EC-P is better than EC-D if pCR is to be determined as a surrogate end-point for prognosis. The patients with anemia or renal insufficiency who need to receive NAC should choose EC-D.

Effect of three or more treatments with lusutrombopag in patients with cirrhotic thrombocytopenia: A retrospective single-center study.

Thrombocytopenia is a common complication among patients with chronic liver disease (CLD). Lusutrombopag, an oral thrombopoietin receptor agonist, is used to reduce the risk of hemorrhage in patients with thrombocytopenia who are undergoing invasive procedures. Platelet transfusion was the standard treatment for thrombocytopenia; however, multiple platelet transfusions lead to the production of antiplatelet antibody. The effect of giving lusutrombopag three times or more has not been previously reported. In this study, we investigated the effect of lusutrombopag readministration in patients with thrombocytopenia. This study included 14 patients (total, 24 readministrations) who received lusutrombopag two times or more. Changes in platelet counts were evaluated. Treatment response was defined as an increased platelet count of ≥20 000/μL after lusutrombopag treatment. Lusutrombopag was given twice in nine patients, three times in three patients, five times in one patient, and six times in one patient. An elevated platelet count of <20 000/μL was noted in only one of the 24 readministrations. There were no postoperative hemorrhagic complications, and no patient had an increased platelet count of >200 000/μL. One patient had a portal venous mural thrombus; however, he was asymptomatic, and the thrombus resolved after anticoagulant treatment, without recurrence. The comparison between the first, second, and third or more treatments showed there was no significant difference in platelet increase. Repeated treatment of lusutrombopag is effective for CLD patients with thrombocytopenia. Moreover, three or more treatments with lusutrombopag showed equal effect compared with one and two treatments with the medication.

Value of the simplified JSTH score criteria in the early diagnosis of sepsis-associated disseminated intravascular coagulation

Objective: To evaluate the early diagnostic value of various indicators in the simplified JSTH score criteria for sepsis-associated disseminated intravascular coagulation (DIC). Methods: A retrospective study was conducted. Patients admitted to Intensive Care Unit (ICU) of the Second Affiliated Hospital of Kunming Medical University from January in 2017 to December in 2018 were enrolled. Totally of 365 patients were recruited, with 224 males and 132 females. The simplified JSTH score criteria was used to diagnose DIC. The patients were divided into sepsis with DIC group and sepsis without DIC group according to the diagnostic criteria of sepsis. Platelet (PLT), fibrin degradation products (FDPs), prothrombin time (PT), antithrombin (AT), acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scores, sequential organ failure assessment (SOFA) scores and the simplified JSTH scores were recorded on the first ICU day. Correlation analyses were conducted.Receiver operating characteristic (ROC) curves for diagnosis of DIC with each indicator were drawn to evaluate the diagnostic efficiency and predictive ability of 28-day mortality. Results: According to the simplified JSTH score, 143 cases of sepsis complicated with DIC were diagnosed. There were significant differences in PLT, FDP, AT, PT, APACHE Ⅱ score, SOFA score, 28-day mortality rate between the two groups (all P<0.01). It was shown by Pearson correlation analysis that the criteria has the best correlation with APACHEⅡ score and SOFA score (r=0.496 and 0.612, both P<0.01). The correlation between PLT and APACHE Ⅱ score or SOFA score was the best (r=-0.440 or-0.568, both P<0.01). It was shown by ROC curve that area under ROC curve (AUC) of PLT was 0.933, and the sensitivity and specificity was 93.0% and 85.0%, respectively. The 28-day mortality was predicted by using the indicators in the criteria. The AUG of AT was 0.813, and both the sensitivity (81.6%) and specificity (73.6%) were the highest. Conclusions: The simplified JSTH score criteria can be used for early diagnosis of sepsis-associated DIC and it is positively correlated with the severity of the disease. The correlation between PLT and the severity of disease is the best, and early diagnosis efficiency of PLT is the strongest. AT has a good predictive value for 28-day mortality.

Characteristics and significance of changes of thrombomodulin and plasma protein C in patients with cancer before and after PICC.

This study aimed to evaluate the changes and clinical significance of thrombomodulin (TM) and plasma protein C (PC) in patients with cancer before and after peripherally inserted central catheter placement (PICC). The levels of plasma TM and PC in 35 patients with cancer before and after PICC were measured by enzyme-linked immunosorbent assay, and the significance of the differences was analyzed. TM was 3.57 ± 1.01 μg/L at 1 day after catheterization, which was significantly lower than the value of 4.41 ± 1.26 μg/L before catheterization; these values were 4.30 ± 1.81 and 4.73 ± 0.97 μg/L at 30 and 90 days after catheterization, respectively (F = 4.14,P < 0.05). PC was 3.32 ± 1.35 μg/L at 1 day after catheterization, which was significantly lower than the value of 5.32 ± 2.12 μg/L before catheterization; these values were 4.64 ± 2.44 and 5.83 ± 3.14 μg/L at 30 and 90 days after catheterization, respectively (F = 6.28,P < 0.01). There were no significant differences in platelet (PLT) counts, plasma D-D, and coagulation parameters among the four time points before and after catheterization. There was a positive correlation between TM and PC (r = 0.5420,P < 0.01) on day 1 after PICC line insertion. The levels of TM and PC were not related to PLT, plasma D-dimer, or various coagulation parameters. The levels of TM and PC in the patients 1 day after PICC were significantly decreased and showed a positive correlation, but were not related to PLT, plasma D-dimer, or coagulation function.

Impact of malaria on haematological parameters of urban, peri-urban and rural patients in the Ashanti region of Ghana: a cross-sectional study

Background: This study aimed at investigating haematological changes in malaria patients across different demographic settlements. Malaria parasites trigger changes in certain haematological parameters, which may result in a number of clinical manifestations. Differences in demographic settlements, such as rural, peri-urban and urban settlements, may also influence these changes, but this has rarely been studied. Methods: We conducted a hospital-based, cross-sectional study from January to December 2018 in three different settlements. A total of 598 participants were recruited. Giemsa-stained blood smears were examined to detect and quantify malaria parasitaemia, while haematological parameters were measured using a haematology analyser. Results: The rural settlement had the highest malaria prevalence compared to the other study communities (p=0.009). The difference in parasite densities across the three communities was also significant (p=0.0149). When the malaria-infected population was compared to the uninfected, there were differences in red blood cell count (p=0.0170), haemoglobin levels (p=0.0165), mean corpuscular volume (p=0.0139) and platelet counts (p<0.0001). The difference in median white blood cell (p-value <0.0001), neutrophil (p-value <0.0001) and lymphocyte (p-value <0.0269) count were significantly higher in infected patients from the peri-urban area compared to malaria patients from the rural and urban areas. There were also significant differences in platelet ( p=0.0002), plateletcrit ( p=0.0041), mean platelet volume ( p=0.0009) and platelet large cell ratio ( p=0.0046) levels between patients from the urban, peri-urban and rural areas. Conclusions: Patients infected with malaria generally had low red blood cell, haemoglobin and platelets in comparison to uninfected patients. There were also significant differences in several haematological parameters between malaria-infected patients from the three demographic settlements. Atypical results from routine haematological assays, especially findings of anaemia and thrombocytopenia, may be indicative of malaria and, in cases where the infection is asymptomatic, may improve diagnosis by prompting a more thorough search for the parasite in the peripheral circulation.

Safety of Antithymocyte Globulin in Patients Undergoing Liver Transplantation With Livers From Donation After Circulatory Death Donors.

Background: Studies suggest that rabbit-antithymocyte globulin (rATG) decreases biliary complications (BCs) after donation-after-circulatory-death-donor liver transplantation (DCD LTx), but safety data are lacking. Objective: Our aim was to assess the safety of rATG for this indication. The secondary end point was efficacy of rATG for this indication. Methods: Adult recipients of DCD LTx were divided into 2 cohorts: protocolized use of rATG in the modern era (July 1, 2013, to December 31, 2016) and a historical control without rATG (January 1, 2005, to June 30, 2013). Incidence of infection, leukopenia, and thrombocytopenia were compared for the safety assessment, incidence of BCs, ischemic cholangiopathy (IC), and transplant outcomes for the efficacy assessment. Results: A total of 83 patients met inclusion criteria: 42 in the historical cohort and 41 in the modern cohort. The modern cohort had significantly fewer bacterial infections at 3 months (historical 54.8% vs modern 23%; P = 0.004) and 1 year (historical 62.1% vs modern 34.2%, P = 0.004). The modern cohort also had fewer fungal infections at these time points (historical 33.3% and 47.9% vs modern 15% and 15%; P = 0.001). There were no significant differences in platelet or white blood cell reduction between groups. There was a nonsignificant, but numerical, trend toward reduced IC/BC in the modern cohort at 1 year (IC: historical 30.1% vs modern 13.2%, P = 0.08; BC: historical 51% vs modern 37.5%, P = 0.13). There was no difference in graft/patient survival. Conclusion and Relevance: Our data suggest no major safety issues with rATG in DCD LTx. Our study should ease clinical apprehension surrounding rATG use for this indication. Future prospective studies are needed to further evaluate the role of rATG and its impact on efficacy end points.

Serum amyloid A protein in identification of disease activity and infection for systemic-onset juvenile idiopathic arthritis

We retrospectively analyzed 126 children with juvenile idiopathic arthritis (JIA) admitted from January to December 2017, including 65 cases of systemic-onset JIA (SoJIA) and 61 cases of other types of JIA. The value of serum amyloid A protein (SAA) in the identification of the disease activity and infection in children with SoJIA was assessed. The area under the ROC curve of SAA in identification of disease activation of SoJIA patients was 0.934, which was not significantly different with other types of JIA. With the cut-off value of 68.32 mg/L the sensitivity and specificity for diagnosis of SoJIA activity were 0.913 and 0.892 respectively. In SoJIA patients the SAA was closely correlated with ESR and CRP (r=0.721 and 0.699, P<0.001). The SAA level was significantly higher in the disease active stage than that in stable stage, in the stable stage with infection than that in the stable stage without infection of SoJIA patients. There were also significant differences in platelet and CRP between active disease with infection and active disease without infection. SAA is expected to be used for assessing disease activity of SoJIA, if combined with platelet and CRP, it may be of value in the identification of the complicating infection. Key words: Serum amyloid A protein; Juvenile idiopathic arthritis; Disease activity; Infection

The epidemiology and clinical characteristics of myeloproliferative neoplasms in Malaysia

BackgroundThe evolution of molecular studies in myeloproliferative neoplasms (MPN) has enlightened us the understanding of this complex disease consisting of polycythaemia vera (PV), essential thrombocythemia (ET) and primary myelofibrosis (PMF). The epidemiology is well described in the western world but not in Asian countries like Malaysia.Materials and methodsThis retrospective national registry of MPN was conducted from year 2009 to 2015 in Malaysia.ResultsA total of 1010 patients were registered over a period of 5 years. The mean age was 54 years with male predominance. The ethnic distribution revealed that Chinese had a relatively high weighted incidence proportion (43.2%), followed by Indian (23.8%), Malay (15.8%) and other ethnic groups (17.2%). The types of MPN reported were 40.4% of ET (n = 408), 38.1% of PV (n = 385), 9.2% of PMF (n = 93), 3.1% of hypereosinophilic syndrome (HES) (n = 31) and 7.9% of unclassifiable MPN (MPN-U) (n = 80). Splenomegaly was only palpable clinically in 32.2% of patients. The positive JAK2 V617F mutation was present in 644 patients with 46.6% in PV, 36.0% in ET, 9.0% in PMF, and 7.4% in MPN-U, and had significantly lower haemoglobin (p < 0.001), haematocrit (p < 0.001) and white blood cells (WBC) (p < 0.001) than those with negative mutation. Significant differences in platelet and WBC count were detected in ethnic groups and MPN sub-types. There were more arterial thrombosis events seen in those with JAK2 V617F mutation as compared to venous thrombosis events (23.1% vs 4.4%). The bleeding rate was only 6.6%. Among the risk factors, previous thrombosis, old age (≥ 60 years) and hypertension were significantly correlated to positive JAK2 V617F mutation. The arterial thrombosis event is associated with higher presenting HB, HCT and PLT while the bleeding event is associated with lower presenting HB, HCT but higher PLT. The presence of JAK2 V617F mutation is associated with higher risk of arterial thrombosis.ConclusionChinese ethnicity is associated with higher rates of MPN. The history of thrombosis, age ≥ 60 years and hypertension are risk factors that can be correlated to JAK2 V617F mutation. This study is instrumental for policy makers to ensure preventive strategies can be implemented in future.

Using additional pressure control lines when connecting a continuous renal replacement therapy device to an extracorporeal membrane oxygenation circuit

BackgroundThe introduction of a continuous renal replacement therapy (CRRT) device into the extracorporeal membrane oxygenation (ECMO) circuit is widely used. However, excessive pressure transmitted to the CRRT device is a major disadvantage. We investigated the effects of using additional pressure control lines on the pressure and the lifespan of the CRRT circuit connected to the ECMO.MethodsThis is an observational study using prospectively collected data from consecutive patients receiving CRRT connected into the ECMO circuit at a university-affiliated, tertiary hospital from January 2013 to December 2016. The CRRT circuit was connected into the ECMO circuit through the Luer Lock connection without an additional pressure control line in 16 patients (9%, no line group), an additional pressure control line on the inlet line in 36 patients (23%, single line group), and additional pressure control lines on both the inlet and outlet lines in 118 patients (77%, double line group). The outcome measures of interest were compared among the three groups.ResultsThe median access pressure was higher in the no line group compared to the groups. However, median filter pressure, effluent pressure, and return pressure were higher in the double line group compared to the other groups. There were no significant differences in platelets, lactate dehydrogenase, and plasma hemoglobin among the 3 groups over the time period studied. Median lifespan of the CRRT circuits in the double line group was 45.0 (29.0–63.7) hours, which was higher compared to 21.8 (11.6–31.8) hours in the no line group and 23.0 (15.0–34.6) hours in the single line group, respectively. In addition, in-hospital mortality was lower in the double line group (48.3%) compared to the no line group (68.8%) and the single line group (75.0%).ConclusionsAdditional tubing can be considered a simple and safe method for pressure control and lengthening circuit survival when connecting the CRRT device to the ECMO circuit.