Whole Blood Viscosity Research Articles

Near-Newtonian Blood Behavior - Is It Good to Be a Camel?

From a certain level of exercise-intensity onward, hematocrit increases in horses, which brings more oxygen carriers into the bloodstream. Camels, however, when used in competitive racing could be even in need of iron supplementation and blood transfusions due to a severe reduction of their available hematocrit compared to their resting hematocrit. Since the extrinsic and intrinsic mechanical properties of camel erythrocytes (RBC) are so different compared to RBCs of other mammals, the question arises whether this observation might be a response to endurance exercise aiming at keeping the RBC count low. Rheometry indicated dromedary camel blood to behave almost Newtonian, which is unique amongst mammals. Shear thinning did increase with the hematocrit, but remained marginal compared to horses. As a result, camel whole blood viscosity (WBV) exceeded horse WBV at high shear rates, an effect, which was significantly augmented when the packed cell volume (PCV) was increased. Therefore, in camels any infusion of RBCs into the bloodstream can increase the cardiac work and the energy input into the endothelium more effectively, which should generate vascular remodeling in the long term. Yielding, however, was completely absent in camel blood, confirming low cohesion between its components at quasi-static flow. Camel blood remained a viscous liquid without a threshold even at unphysiologically high PCVs. This can help to washout lactate when camels start to dehydrate and might contribute to the sustained working ability of these animals. The subtle pseudoplastic behavior and the high viscosity contrast across the RBC membrane point to weak coupling between blood flow and red cell behavior. We predict that RBCs flow as separate entities and can show various types of motion, which can lead to friction instead of being collectively aligned to the flow direction. In comparison to horses, this behavior will become relevant at higher RBC counts in front of flow obstacles and possibly cause vascular remodeling if the PCV rises during strenuous exercise, a matter that should be avoided.

UPLC-Q-TOF/MS-Based Plasma Metabolomics to Evaluate the Effects of Aspirin Eugenol Ester on Blood Stasis in Rats.

Aspirin eugenol ester (AEE) is a novel compound that is formed from the esterification of aspirin (acetylsalicylic acid (ASA)) and eugenol. This study aimed to investigate the effects of AEE on blood stasis in rats and to characterize the underlying mechanisms using a plasma metabolomic study. The results indicate that AEE and ASA could modulate whole blood viscosity (WBV), plasma viscosity (PV), blood coagulation parameters, platelet count, platelet aggregation, lactate dehydrogenase (LDH), creatinine (CR) and the levels of thromboxane A2 (TXA2) and 6-keto prostaglandin F1α (6-keto-PGF1α). The metabolic profiles of the plasma samples from all groups were clearly separated in the score plots. Nineteen potential metabolites were selected and identified, and disordered levels of these metabolites could be regulated by AEE and ASA. Pathway analysis showed that the mechanism of action of AEE on blood stasis might be principally related to the metabolism of amino acid, fatty acid, energy and glycerophospholipid. The above results indicate that AEE protected the rats against blood stasis, and that this effect might have been caused by the anticoagulation activity of AEE and its abilities to maintain a balance between TXA2 and PGI2, reduce blood viscosity, inhibit platelet aggregation and normalize the plasma metabolic profile.

Whole blood viscosity in systemic sclerosis: a potential biomarker of pulmonary hypertension?

Our goal was to determine if whole blood viscosity (WBV) can be used to predict the risk of pulmonary arterial hypertension (PAH) in patients with systemic sclerosis (SSc). Patients with SSc were analyzed. Out of 107 patients, 26 patients, found to have confirmed diagnosis of PAH, were classified as those with (n= 26, PAH group) and without PAH (n= 81, non-PAH group). We calculated estimated WBV at both high (HSR) and low shear rates (LSR) from hematocrit and total serum protein levels. Total protein levels were significantly higher and the anti-centromere antibody (ACA) was more frequent in the PAH group. Furthermore, anti-topoisomerase antibody (anti-scl-70) was significantly less frequent in the PAH group. The WBV values were significantly higher at HSR (16.68 ± 0.38 vs. 16.24 ± 0.58; p< 0.001) and at LSR (51.81 ± 7.21 vs. 42.97 ± 11.76; p< 0.001) in PAH group. The multivariate analysis revealed that the WBV at both shear rates independently designated the presence of PAH in SSc patients. The ROC curve showed that the sensitivity and specificity of LSR and HSR were 92.3% and 61.7% (AUC 0.759, p< 0.001), and 88.5% and 65.4% (AUC 0.770, p< 0.001) with a cutoff value of 43.56 and 16.32 for WBV, respectively. Higher WBV levels in SSc patients were an independent indicator for PAH development in this cohort. WBV-LSR and WBV-HSR values might help exclude the PAH possibility in patients diagnosed with SSc and remain as an independently associated biomarker for follow-up of these patients for future risk of PAH development. Findings remain to be confirmed by other cohorts.Key Points• The most important cause of morbidity and mortality in systemic sclerosis patients is considered to be pulmonary arterial hypertension.• When the symptoms of PAH are not recognized earlier in the course of the SSc, the prognosis might be worse.• Higher whole blood viscosity levels in scleroderma patients with PAH was an independent indicator for PAH development.

Effect of Comprehensive Cerebral Protection Program on Cerebral Oxygen Metabolism and Vascular Endothelial Function in Elderly Patients with Acute Cerebral Infarction

We aimed to explore the effect of comprehensive cerebral protection on cerebral oxygen metabolism and vascular endothelial function in elderly patients with acute cerebral infarction. A total of 168 elderly patients with acute cerebral infarction treated in The First Affiliated Hospital of Nanchang University, China from January 2016 to January 2018 were selected. The patients were divided into a control group and an observation group using random number method, n=84. Patients in the observation group were given comprehensive cerebral protection treatment, and patients in the control group were treated with conventional standardized treatments. The changes of cerebral oxygen metabolism, hemorheology and vascular endothelial function before and after treatment were compared between the two groups. After treatment, oxygen content in arteries and internal jugular veins (Da-vO2), ofoxygen uptake fraction (OEF), Oxygen saturation (SpO2), nitric oxide (NO) were increased in both groups in comparison to before treatment, jugular venous oxygen saturation (SjvO2), brain oxygen uptake rate (ERO2), endothelin (ET), intracranial pressure (ICP), whole blood viscosity, plasma viscosity, reduced viscosity of whole blood, and hematocrit were decreased. However, the changes in the observation group were larger than those in the control group, the difference was statistically significant (P<0.05). The treatment of cerebral infarction in elderly patients with acute cerebral infarction can effectively improve the cerebral oxygen metabolism and vascular endothelial function and improve the blood rheology, which has important clinical value.

Effect of warfarin versus aspirin on blood viscosity in cardioembolic stroke with atrial fibrillation: a prospective clinical trial

BackgroundWarfarin is evidence-based therapy for the prevention of cardioembolic stroke, but has not been studied for its effects on whole blood viscosity (WBV). This study investigated the effect of warfarin versus aspirin on WBV in patients presenting with non-valvular atrial fibrillation (NVAF) and acute cardioembolic stroke.MethodsWe enrolled patients with acute cerebral infarction, aged 56–90 years who had NVAF, CHADS2 score ≥ 2, presenting with mild-to-moderate stroke (National Institute of Health Stroke Scale (NIHSS) score < 20 and modified Rankin Scale (2mRS) score < 4) in a single center. The patients were alternately assigned to warfarin or aspirin groups. Post-treatment WBV was assessed after international normalized ratio (INR) reached target range [2, 3] for patients in the warfarin group, and 5 days after baseline in the aspirin group.ResultsTotal 67 patients were included, and 56 completed this study (33 warfarin and 23 aspirin). Compared to baseline values, warfarin reduced post-treatment BV at all shear rates. The BV reductions greater than 1 cP measured at shear rates of 300, 150, 5, and 1 s− 1 were independently and significantly associated with warfarin treatment compared to aspirin after adjusting for age, sex, CHA2DS2-VASc scores, and baseline hematocrit.ConclusionsWarfarin confers greater reductions in BV than aspirin in patients with acute cardioembolic stroke. BV could be a useful method to estimate thrombotic risk in patients receiving warfarin.Trial registrationKCT0001291, Date of Registration: 2014-12-01

Spectral noise-to-signal ratio priority method with application for visible and near-infrared analysis of whole blood viscosity.

Whole blood viscosity (WBV) is a group of important clinical indicators of cardio-cerebral vascular diseases. Existing detection methods for WBV are complex, making them inconvenient for large population screening. Blood viscosity is closely related to the deformability and aggregation of erythrocytes, which are associated with haemoglobin. Haemoglobin has obvious near-infrared (NIR) spectral absorption. Scattering occurs when NIR light enters a viscous blood sample, and its scattering degree is correlated with blood viscosity. Based on repeated spectral measurements and spectral similarity, spectral noise-to-signal ratio (NSR) was proposed to quantify the spectral scattering effect in the blood sample. A novel selection method of piecewise-continuous wavelengths, named NSR priority-partial least squares (NSRP-PLS), was proposed and applied for visible-NIR quantitative analysis of WBV with high, medium and low shear rates [WBV(H), WBV(M), WBV(L)]. Modelling was separately performed by gender to allow for systematic gender differences in blood viscosity. For the NIR-predicted and clinically measured values of the three WBV indicators in independent validation, the root mean square errors for prediction (SEP) were 0.498, 0.222 and 0.193 (mPa·s), respectively. And the correlation coefficients (RP) were 0.927, 0.934 and 0.927, respectively. Compared with the three current well-performing methods (MW-PLS, CARS-PLS and SPA-PLS), the proposed NSRP-PLS method achieved better predictive accuracy. Results indicated that visible-NIR spectroscopy combined with the NSRP-PLS method can be used for the quantitative analysis of WBV. The proposed analytical method is rapid, reagent-free and is scientific and meaningful for cardio-cerebral vascular diseases screening in large populations.

Haemorheological and haemostatic alterations in coeliac disease and inflammatory bowel disease in comparison with non-coeliac, non-IBD subjects (HERMES): a case–control study protocol

IntroductionHaemorheological and haemostatic changes predispose to the development of arterial and venous thrombotic events; however, limited information is available on the status of these changes in coeliac disease (CeD) and...

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

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

Application of limbs and fingers movement combined with moxibustion in patients with PICC catheterization

Objective To explore the application of limbs and fingers movement combined with moxibustion in patients with PICC catheterization. Methods A total of 346 PICC catheterized patients treated from August 2014 to July 2017 were randomly divided into control group (173 cases) and observation group (173 cases) according to random number table method. The control group was given local hot-wet compression at 3-4 cm of puncture point after 24 h of catheterization, and the observation group was given preventive moxibustion with the direction of the punctured vein at the same site in the control group, and then was given limbs and fingers movement. The levels of serum monocyte chemoattractant protein-1 (MCP-1), tumor necrosis factor-α (TNF-α) and interleukin-8 (IL-8), hemorheological parameters [rate of high and low shear whole blood viscosity (RBV), rate of plasma specific viscosity (RPV), hematocrit (HCT)] and the incidence rates of mechanical phlebitis and venous thrombosis were compared between the two groups after intervention. Results The levels of MCP-1, TNF-α and IL-8 were (53.03±7.86), (85.93±10.72), (54.65±9.23) ng/L in the observation group, (60.27±8.45), (94.74±11.36), (63.08±10.07) ng/L in the control group, and there were significant differences (t =8.252, 7.419, 8.117, all P<0.05). The levels of high shear RBV, low shear RBV, RPV and HCT were (3.94±0.85) mPa·s, (6.55±1.22) mPa·s, (1.70±0.54) mPa·s and (43.71±4.82)% respectively in the observation group, (4.18±0.74) mPa·s, (6.97±1.25) mPa·s, (1.92±0.59) mPa·s and (45.13±4.65)% in the control group, and there were significant differences (t=2.789-3.618, P<0.05). The incidence rates of venous thrombosis and phlebitis were 1.16% (2/173) and 5.78% (10/173) respectively in the observation group, 5.78% (10/173) and 13.29% (23/173) in the control group, there were significant differences (χ2=4.230, 5.661, P<0.05). Conclusions Limbs and fingers movement combined with moxibustion can effectively improve the blood flow status, and reduce the occurrence of mechanical phlebitis and venous thrombosis in patients with PICC catheterization. Key words: PICC catheterization; Moxibustion; Mechanical phlebitis; Venous thrombosis; Limbs and fingers movement

The association of estimated whole blood viscosity with hemodynamic parameters and prognosis in patients with heart failure.

We aimed to investigate the association of estimated whole blood viscosity (WBV) with hemodynamic parameters and prognosis in patients with heart failure with reduced ejection fraction. Total of 542 patients were included and followed-up for median 13 months. The WBV parameters had negative relationship with right atrium pressure and positive correlation with cardiac index. The WBV parameters were found to be independent predictors of composite end point (CEP) and all-cause mortality. Every one cP increases of WBV(h) and WBV(l) were associated with 17 and 1% reductions of CEP. In Kaplan-Meier analysis, patients with low WBV quartiles were found to have significantly more CEP. Being an easily accessible and costless prognosticator, WBV seems to be a novel marker for determining prognosis and an emerging tool to individualize heart failure with reduced ejection fraction management.

Association between Blood Viscosity and Cardiovascular Risk Factors in Patients with Arterial Hypertension in a High Altitude Setting.

Background Blood viscosity is a determinant of vascular resistance, and it is expected to contribute to blood pressure. Arterial hypertension (HTN), in addition to other cardiovascular risk factors, contribute to cardiac morbidity. Our study aimed to establish the association between cardiovascular risk factors including HTN and whole blood viscosity in Ecuadorian patients.Material and methodsWe studied 132 patients with the diagnosis of HTN. Fifteen cardiovascular risk factors were analyzed. The association between whole blood viscosity (WBV) and the number of cardiovascular risk factors was studied. The association between blood viscosity and risk factors was analyzed.Results One hundred and thirty-two patients were analyzed. Blood viscosity was associated with a number of cardiovascular risk factors. Creatinine, uric acid, total cholesterol, and low-density lipoprotein (LDL) values were significantly higher in patients with high blood viscosity.Conclusion Blood viscosity is a physiological variable associated with a number of cardiovascular risk factors in hypertensive patients. Such risk factors are related to renal function and lipid profiles. In high-altitude residents, polycythemia is common, and the consequences of high hematocrit on cardiovascular morbidity in this setting deserve special attention and warrant further research.

Age and gender specific variations of selected hemorheological variables in humans

Over the last decades, investigations have shown that the physical and mechanical damage of red blood corpuscles may significantly affect the fluency and diffusion state of blood flow, alongside internal viscosity and fibrinolytic activities of the cardiovascular system that houses it. Current study was thus envisioned to investigate gender and age differences in selected hemo-rheological parameters [pH, Whole Blood Viscosity (WV), Plasma Viscosity (PV), Plasma Fibrinogen Concentration (PFC), Packed Cell Volume (PCV) and Euglobinlysis time (ELT)] of adult humans. One hundred and forty (140) participants of seventy two (72) males and sixty eight (68) female subjects were ethically approached from the staff and students’ community of the University of Benin, Edo state, Nigeria. Participants’ health status was carefully obtained by means of history taking and questionnaire, following which individuals were grouped into two based on gender. For each gender, subjects were sub-grouped into the ages of 31-40 years, 41-50 years, 51-60 years, and 61-70 years based on reported incidences (by age) of hemo-rheological anomalies. For each subject, blood samples were obtained and assayed for aforementioned hemo-rheological changes. Statistical comparison (using the one way analysis of variance - ANOVA) was then conducted on collected samples for comparison of differences in mean between groups. From obtained result, study found a statistically insignificant difference in all but WV across gender and age lines, with slight increase in all other parameters. However, none of the parameters was significantly different across age groups, suggestive that the parameters do not differ across age group in the male participants.

The Relationship between Blood Viscosity and Isolated Coronary Artery Ectasia.

It is unclear whether isolated coronary artery ectasia (iCAE) is associated with whole blood viscosity (WBV). In the present study, we investigated WBV in coronary artery ectasia (CAE) patients. Seventy-eight patients with iCAE and 83 controls with normal coronary arteries were selected from 12290 patients who underwent coronary angiography between January 2014 and December 2017. WBV was calculated with a validated equation from hematocrit and total plasma protein levels for a low (LSR) and high (HSR) shear rate. Baseline demographic characteristics and medical history of the groups were similar. The mean level of C-reactive protein (2.1 ± 0.53 vs. 1.93 ± 0.44; p = 0.042) and total protein (7.2 ± 0.3 vs. 7.0 ± 0.6; p = 0.009) were significantly higher in the iCAE group than in the control subjects. Both HSR (4.57 ± 0.6 vs. 3.9 ± 0.7; p < 0.001) and LSR (33.5 ± 9.6 vs. 25.1 ± 9.2; p < 0.001) levels were significantly higher in the iCAE group than in the control group. In ROC analysis, a cut-off value of 4.19 WBV for HSR had an 80.8% sensitivity and 72.3% specificity [area under the curve (AUC): 0.779, 95% CI 70.6-85.1; p < 0.001] and a cut-off value of 27.5 WBV for LSR had an 80.1% sensitivity and 72.3% specificity for predicting iCAE (AUC: 0.788, 95% CI 71.4-86.2; p < 0.001). In multivariate analysis, both LSR (p < 0.001, OR 1.10, 95% CI 1.05-1.15) and HSR (p < 0.001, OR 4.60, 95% CI 2.33-9.09) were independent predictors for the presence of iCAE. In the present study, we determined that in WBV, both HSR and LSR were significantly higher in the iCAE group than in the control subjects, and that this may be a possible cause of iCAE.

Evaluation of blood rheology by patients with acute ischemic stroke with Mexidol administration

Sixty patients with acute stroke, including 32 patients who received mexidol (500 mg/IV/20 days) and 28 people who received magnesium sulfate (2000 mg/IV/20 days) were examined. The control group included 20 people without a cardiovascular pathology. Blood rheology (viscosity of whole blood, plasma viscosity, hematocrit, aggregation and deformability of erythrocytes, fibrinogen level) was evaluated in patients three times: for the first 12 hours, 3-5 days and 18-20 days after hospitalization. Hyperviscosity syndrome was observed in all patients with stroke. A significant decrease in blood viscosity was found in patients treated with mexidol: in the 3-5th day at low shear rates and in the 18-20th day at 3-100 s-1 shear rates. Significant differences in hematocrit (p=0.026) and fibrinogen levels (p=0.017) in patients treated with different drugs were found in the 18-20th day of the disease. Higher erythrocyte deformability index was recorded in patients treated with mexidol in the 3-5th day at shear rates of 90 and 890 s-1, in the 18-20th day at shear rates of 90-360 s-1. The study confirms the impact of mexidol on the fluidity of blood during the acute cerebral ischemia and shows its efficacy in reducing blood viscosity, decreasing the level of hematocrit and fibrinogen, increasing the deformability of erythrocytes.

Evaluation antithrombotic activity and action mechanism of myricitrin

Myricitrin was isolated from Cercis chinensis leaves and its antithrombotic activity was evaluated by activated partial thromboplastin time (APTT), thrombin time (TT), prothrombin time (PT), and fibrinogen (FIB) in vitro and rat acute blood stasis model in vivo. APTT, PT and TT were significantly prolonged and plasma FIB was significantly shortened in myricitrin group compared with model group in vitro. In rat acute blood stasis model, myricitrin (5 mg/mL and 2.5 mg/mL) could extend APTT, PT and TT, increase the level of 6-keto prostaglandin F1α (6-keto-PGF1α) and nitric oxide synthase (eNOS), decrease the level of plasma FIB, thromboxane B2 (TXB2), endothelin-1 (ET-1), blood sedimentation (ESR), hematocrit (PCV), whole blood viscosity (WBV) and plasma viscosity (PV). All of above revealed that myricitrin had good antithrombotic effects.

Amlodipine alters hemorheological parameters: Increased efficacy at the cost of edema?

BackgroundDespite several decades of use of calcium channel blockers, the side effect of edema persists as a class effect, and its mechanism is unresolved. Amlodipine has effects on hemorheology (HR), and its hemodilutory property may partly contribute to its antihypertensive action. This aspect is not well studied, and the literature is sparse in this regard. ObjectiveThis experiment was planned to determine effect of a single-dose administration of amlodipine on HR parameters in normal human volunteers. Methods and resultsAmlodipine (5 mg) or S (-) amlodipine (2.5 mg) was administered to 27 normal human volunteers. Whole-blood viscosity (WBV) at different shear rates, plasma viscosity (PV), red cell rigidity (RCR), red cell aggregation (RCA), hematocrit (Hct), plasma hemoglobin, along with plasma drug concentration were determined at time intervals, t = 0, 4, 8, 12, and 24 h. Statistically significant reductions were observed at tmax = 4 h in WBV at shear rates of 0.512 s–1 (p < 0.005), WBV at shear rates of 5.26 s–1 (p < 0.01), PV (p < 0.05), and Hct (p < 0.01). At t = 8 h, as drug concentration reduced, some of the changes persisted and later slowly decreased with the decreasing drug concentration till t = 24 h. Red blood cell–related parameters such as RCA and RCR remained unaltered. WBV values at all shear rates, when corrected for Hct = 0.45, did not show deviation from their original values at any time. ConclusionsAmlodipine causes a reduction in Hct and blood viscosity, along with hemodilution. These effects persist as long as the drug remains in plasma. Edema resulting from chronic dosing may be explained by the aforementioned effects. It is possible that antihypertensive action of the drug may be due to a combination of vasodilatation and an improvement in the HR properties.

Dazhu Hongjingtian (Herba Rhodiolae) for unstable angina pectoris: Protocol for a systematic review and meta-analysis.

BackgroundDazhu Hongjingtian (DZHJT), also named Herba Rhodiolae, has been frequently introduced for patients with angina pectoris in China. However, the add-on effect of DZHJT in unstable angina pectoris (UAP) has not been systematically evaluated. The purpose of this protocol is to provide the methods used to assess the efficacy and safety of DZHJT as adjuvant therapy for management of UAP.MethodsWe will extensively search for eligible studies in PubMed, Emase, Cochrane Library, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang, and VIP databases up to October 2018. Only randomized controlled trials comparing DZHJT in combination with Western medicine vs Western medicine alone were selected.The primary outcomes are above 50% reduction in frequency of angina attacks and weekly frequency of angina attacks reduction. The secondary outcomes are the blood rheology parameters (whole-blood viscosity, plasma viscosity, and fibrinogen) and adverse events. We will use RevMan V.5.0 software to perform meta-analysis.ResultsThe pooled results will provide a high-quality of evidence of DZHJT as adjuvant therapy in patients with UAP.ConclusionThis systematic review and meta-analysis will provide up-to-date evidence to evaluate DZHJT as adjuvant therapy in patients with UAP.PROSPERO registration numberPROSPERO CRD42018111885.

Resonant Acoustic Tweezing Spectroscopy for Small-Volume Noncontact Assessment of Blood Coagulation

Introduction: Measurement and interpretation of mechanical properties of whole blood and blood plasma are important diagnosis and treatment monitoring of various conditions like coagulopathy, hemophilia, sickle cell disease and many cardiovascular disorders. Many of the current techniques like thromboelastography, micro-viscometry or microfluidic devices used for this purpose require a large sample volume and/or may be prone to measurement errors due to sample contact with device walls. To address these issues, we developed a single-drop non-contact method for blood rheological analysis, referred to as “acoustic tweezing rheometry”. With sample volume as small as 4 μL, our innovative technology has been successfully applied for assessment of whole blood and blood plasma coagulation. Here, we present the extension of this technology to resonant spectroscopic measurement of blood viscoelasticity.Materials and Methods: The schematic of the acoustic tweezing device is shown in (Figure 1A). The standing acoustic wave field between the transducer and reflector generates the acoustic radiation force on the biological sample that traps it in a host fluid (e.g., air). Sample tweezing (force-induced deformation and translational motion of the trapped sample) is achieved by amplitude modulation of the acoustic tweezing signal at high frequency and then decrease the frequency continuously until the lower limit for sample trapping is reached. During this frequency sweep, shape changes of the sample were recorded (Figure 1B) by a photodetector and a high-speed camera (Figure 1A). The amplitude-frequency response of the sample was obtained from raw data analysis, with the amplitude being the maximum deflection of the sample height from its equilibrium value. Dynamic (shear) viscosity and elasticity of the sample were assessed from the quality factor of the amplitude-frequency response (Figure 1C) and the resonance frequency, respectively.Results and Discussion: The quality factor analysis predicted that the dynamic viscosity of commercial normal control blood plasma was 1.5 mPa·s at room temperature, which agreed with previous large-sample-volume measurements. Once re-calcified, the resonance frequency of blood plasma and thus its shear elasticity increased due to clot formation until reaching a plateau in 5 min (Figure 1D). Using this graphical output (referred to as “tweezograph”), the following coagulation parameters can be extracted: clot initiation time, clotting rate, clotting time, and maximum clot elasticity.Conclusions: Resonant acoustic tweezing spectroscopy can accurately measure dynamic viscosity and elasticity of whole blood and blood plasma with a small drop of the sample and without artefacts or measurement errors due to sample contact with device walls. This technique can be applied for rapid assessment of whole blood and blood plasma coagulation.Acknowledgments: This study has been supported by U.S. National Science Foundation grant 1438537, American Heart Association Grant-in-Aid 13GRNT17200013, and Tulane University intramural grants. The acoustic tweezing technology is protected by pending patents PCT/US14/55559 and PCT/US2018/014879. [Display omitted] DisclosuresKhismatullin:Levisonics Inc: Equity Ownership, Membership on an entity's Board of Directors or advisory committees, Patents & Royalties.

Protective effects of shenfu injection on cerebral ischemia reperfusion injury in rats

Objective To study the protective effect of shenfu injection on cerebral ischemia reperfusion injury in rats. Methods 120 male Sprague Dawley (SD) rats(320-350 g) were randomly divided into sham operation group, model control group, Nimodipine injection group, low, medium and high dose group of shenfu injection according to gender weight. 20 males in each group were given medicine once a day for 7 days before operation. The cerebral ischemia model was established by thread embolization after 5 days of administration. In the sham operation group, the other operations were the same as those in the model group except for carotid artery ligation and thread insertion. After 24 hours of perfusion, the neurological score, abdominal aorta blood flow, malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione (GHS) levels in brain tissues were measured. Triphenyltetrazolium chloride (TTC) staining was used to calculate the area of cerebral infarction and pathological examination of brain tissues. Results Compared with the model control group, the middle and high dosage of shenfu injection could obviously improve the nerve function and increase the percentage of cerebral infarction area (P<0.05); the high dosage group of shenfu injection could obviously decrease the whole blood viscosity (P<0.01); the middle and high dosage of shenfu injection could obviously reduce the level of MDA in rat brain tissue (P<0.01) while increasing the levels of SOD and GSH (P<0.01), finally could significantly improve the pathological changes of brain issues such as mild swelling of nerve fibers, mild neuronal degeneration, inflammatory interstitial edema and inflammation. Conclusions Shenfu injection has obvious protective effect on cerebral ischemia reperfusion model in rats. Key words: SHENFU DECOCTION/TU; Ischemic preconditioning; Brain ischemia; Reperfusion injury/DT; Rats

Plasmapheresis for hypertriglyceridemia: The association between blood viscosity and triglyceride clearance rate.

Several factors in double filtration plasmapheresis (DFPP) were associated with triglyceride (TG) clearance rate. This study examines whether baseline whole blood viscosity was a predictor for efficient TG removal. Adult subjects who receiving DFPP for hyperlipidemia in Taoyuan General Hospital from January 2015 to March 2018 were classified into efficient and inefficient TG removal according to TG removal rate ≥50% vs <50%. TG removal rate was defined as following formula: (pre-apheresis TG- post-apheresis TG)/pre-apheresis TG. Whole blood viscosity (WBV) was estimated by following equation: WBV=0.12×hematocrit +0.17×(total protein -2.07). Univariate linear regression was used to assess the association between TG removal rate and WBV. Odds ratios (ORs) and 95% confidence interval (95%CI) for associations between variables and efficient TG removal were evaluated by logistic regression model to including univariate and multivariate adjustment. From a total of 66 subjects receiving DFPP, 37 subjects reached efficient TG removal. The difference in pre-apheresis TG levels, hematocrit, and WBV between efficient vs. inefficient TG removal groups was 4.1 vs 6.7mmol/L; 43.1% vs 39.5%; and 6.0cP vs 5.cP (Ps <0.05). After multivariate adjustment, WBC was a significant predictor for efficient TG removal (ORs and 95% CI were 3.192 (1.300-7.838), P<0.05). The correlation between WBV and extraction of TG was significant (r=-0.255, P=0.039). Hyperviscosity reduced the efficiency of TG removal in those receiving DFPP.