藕节止血作用研究

本实验通过测定毛细管凝血时间(CT)、剪尾法出血时间(BT)、活化部分凝血酶时间(APTT)、凝血酶原时间(PT)、凝血酶时间(TT)、优球蛋白溶解时间(ELT)等指标研究藕节醇提物及其不同极性段的体内止血作用.结果表明,藕节醇提物显著缩短小鼠CT、BT,显示很好的止血作用,可能是主要通过缩短APTT、PT,延长ELT...     

叶下珠有效部位对血栓形成的影响及其作用机制初探

采用Born方法和改良的Hamburger方法分别测定叶下珠 (Phyllanthusurinaria)含corilagin的有效部位 (代号PUW )在体内外对血小板聚集功能和对血小板与中性粒细胞之间粘附反应的影响 ;应用Myers方法评价PUW灌胃对小鼠尾静脉注射花生四烯酸 (AA)引起猝死的保护作用 ;运用改良的Charl ton方法及陈长勋等方法分别观察PUW灌胃对电刺激大鼠颈动脉血栓形成和下腔静脉血栓形成的影响 ;采用Tomihisa方法 ,观察PUW对大鼠尾尖出血时间的影响。结果显示 ,PUW在体内外对ADP、AA或血小板活化因子 (PAF)诱导的血小板聚集均无明显抑制作用 ;PUW呈浓度依赖性明显阻抑AA激活的血小板与中性粒细胞之间的粘附反应 ,其半数抑制浓度 (IC50 )为 39 7mg/kg。PUW (10、2 0和 4 0mg/kg)灌胃呈剂量依赖性显著减少AA致小鼠死亡的数量 ,明显延长电刺激大鼠颈动脉血栓形成时间 ,减轻大鼠下腔静脉血栓的干、湿重。 2 0mg/kg的PUW对出血时间无明显影响 ,4 0mg/kg的PUW虽延长出血时间 ,但与阿司匹林 (2 0mg/kg)比较 ,出血时间明显缩短 (P <0 0 5 )。本实验结果提示 ,PUW灌胃在多种体内血栓模型中均具有明显的抗血栓形成作用 ,其机制可能与阻抑血小板和中性粒细胞之间的的粘附作用密切相关。     

单气囊小肠镜与胶囊内镜对不明原因消化道出血的诊断价值

目的:探讨单气囊小肠镜(SBE)与胶囊内镜(CE)对不明原因消化道出血(OGffi)患者的诊断价值。方法:将在我院治疗的100例OGIB患者按照诊断方式的不同分为SBE组和CE组各50例。对两组的病灶检出率病因诊断率以及安全性进行比较。结果SBE组病因诊断率为78.0%;CE组病因诊断率为60.0%,两组病因诊断率比较差异无统计学意义(P0.05)。SBE组病灶检出率为80.0%(40/50),CE组病灶检出率为86.0%(43/50),两组病灶检出率比较差异无统计学意义(P0.05)。SBE组患者检查较顺利,CE组胶囊滞留率为4.0%。所有患者检查后均未出现不良反应及并发症。结论:息肉及粘膜糜烂渍疡病变的OGIB患者在SBE与CE检查方法中较为常见,CE病灶检出率与SBE相当,两种检查方法均较可靠,CE检查更为方便。     

巴中地区上消化道出血反复发作相关性因素分析

目的：了解巴中地区上消化道出血反复发作的原因,为治疗提供临床循证医学证据。方法：通过对2011年4月~2012年11月巴中地区1134例上消化道出血中132例反复发作的患者进行调查统计,分析这上消化道出血反复发作的132例患者的年龄、生理特征、生活饮食习惯、精神状态、生活压力等多种相关因素。结果：发现饮食不当、精神紧张、腹腔感染、腹腔内压增高、输液输血过速、过量等是造成病情反复发作的主要诱因。结论：通过消除疾病的诱发因素,认真做好健康教育指导,积极治疗原发病是预防反复发作的有效措施。     

Evaluation of nongenotoxic and genotoxic factors modulating the frequency of micronucleated erythrocytes in the peripheral blood of mice

The hematological micronucleus test is regarded as an indicator of the clastogenic effect of chemicals and acute cytogenetic damage. The test can be carried out in red blood cells of the bone marrow and of the spleen, as well as in peripheral erythrocytes. We have determined the precise background values of micronucleated red blood cells for the peripheral blood of BALB/c DBA/2, and NMRI mice. Bleeding, phenylhydrazine-induced hemolysis, and splenectomy generated an increase of micronucleated erythrocytes in the peripheral blood of mice. Our data thus demonstrate that such factors should be taken into consideration when the micronucleus test is used for screening the genotoxic potential of chemicals. Furthermore, the micronucleus-inducing effect of cyclophosphamide was studied in normal and splenectomized mice and, in addition, a comparison of the sensitivity of the micronucleus test was carried out in peripheral blood and bone marrow after cyclophosphamide treatment. Our data demonstrate that the kinetics of micronucleus formation were similar in normal and in splenectomized mice in which the micronucleus levels had returned to normal. The comparison of micronucleus formation in bone marrow and peripheral blood after cyclophosphamide treatment revealed the generation of similar quantities of micronucleated red blood cells in both tissues. The physiological mechanisms of micronucleus formation and removal and the potential role of chemically induced spleen damage during this process are discussed; the usefulness of the peripheral micronucleus test as a simple, rapid, and animal-saving modification of the standard bone marrow test is evaluated.Abbreviations CP cyclophosphamide - MN micronuclei - MNCE micronucleated normochromatic erythrocytes - MNPCE micronucleated polychromatic erythrocytes - MNRBC micronucleated red blood cells - NCE normochromatic erythrocytes - PCE polychromatic erythrocytes     

A novel naphthalimide derivative reduces platelet activation and thrombus formation via suppressing GPVI

Naphthalimide derivatives have multiple biological activities, including antitumour and anti-inflammatory activities. We previously synthesized several naphthalimide derivatives; of them, compound 5 was found to exert the strongest inhibitory effect on human DNA topoisomerase II activity. However, the effects of naphthalimide derivatives on platelet activation have not yet been investigated. Therefore, the mechanism underlying the antiplatelet activity of compound 5 was determined in this study. The data revealed that compound 5 (5–10 μM) inhibited collagen- and convulxin- but not thrombin- or U46619-mediated platelet aggregation, suggesting that compound 5 is more sensitive to the inhibition of glycoprotein VI (GPVI) signalling. Indeed, compound 5 could inhibit the phosphorylation of signalling molecules downstream of GPVI, followed by the inhibition of calcium mobilization, granule release and GPIIb/IIIa activation. Moreover, compound 5 prevented pulmonary embolism and prolonged the occlusion time, but tended to prolong the bleeding time, indicating that it can prevent thrombus formation but may increase bleeding risk. This study is the first to demonstrate that the naphthalimide derivative compound 5 exerts antiplatelet and antithrombotic effects. Future studies should modify compound 5 to synthesize more potent and efficient antiplatelet agents while minimizing bleeding risk, which may offer a therapeutic potential for cardiovascular diseases.     

Risk of hospitalization for upper gastrointestinal bleeding in Helicobacter pylori eradicated patients newly started on warfarin or direct oral anticoagulants: A population-based cohort study

Background

To investigate risks of hospitalization for upper gastrointestinal bleeding (UGIB) in H. pylori-eradicated patients newly started on warfarin or direct oral anti-coagulants (DOACs).

Methods

We identified all patients who had previously received H. pylori eradication therapy or were found to have no H. pylori on endoscopy and were then newly started on warfarin or DOACs from a population-based electronic healthcare database. Primary analysis was the risk of UGIB between warfarin and DOACs users in H. pylori-eradicated patients. Secondary analysis included the UGIB risk between H. pylori-eradicated and H. pylori-negative patients who were newly started on warfarin or DOACs. The hazard ratio (HR) of UGIB was approximated by pooled logistic regression model incorporating the inverse propensity of treatment weightings with time-varying covariables.

Results

Among H. pylori-eradicated patients, DOACs had a significantly lower risk of UGIB (HR: 0.26, 95% CI 0.09–0.71) compared with warfarin. In particular, lower UGIB risks with DOACs were observed among older ( ≥ 65 years) patients, female, those without a history of UGIB or peptic ulcer, or ischemic heart disease, and non-users of acid-suppressive agents or aspirin. Secondary analysis showed no significant difference in UGIB risk between H. pylori-eradicated and H. pylori-negative patients newly started on warfarin (HR: 0.63,95% CI 0.33–1.19) or DOACs (HR: 1.37, 95% CI 0.45–4.22).

Conclusions

In H. pylori-eradicated patients, new users of DOACs had a significantly lower risk of UGIB than new warfarin users. Furthermore, the risk of UGIB in new warfarin or DOACs users was comparable between H. pylori-eradicated and H. pylori-negative patients.     

The effect of heavy bleeding on mortality of the horseshoe crab, Limulus polyphemus, in the natural environment

The goal of this study was to ascertain the impact of bleeding such as is done to produce Limulus lysate (LAL) on a horseshoe crab population after animals are returned to the natural environment. Techniques used to evaluate the impact of bleeding on subsequent survival included a field tagging experiment and an analysis of survival in the laboratory after bleeding. Approximately 10,000 mature Limulus polyphemus were collected, described, and individually tagged. Half were bled and half were handled as controls. All were released into the field. An analysis of the rate of tag recovery for the two groups indicates that bleeding increases mortality by 10% during the first year after bleeding. Crabs rebled after 4 weeks at large had recovered their blood volume. Animals recovered during the second year showed an 11% increase in mortality of bled over control animals. Animals held in the laboratory showed no significant differences in activity after bleeding as compared to unbled controls. Lysate bleeding followed by release of the animals does not appear to constitute a threat to current population levels of L. polyphemus.     

Do “glanduliferous” larvae of Galerucinae (Coleoptera: Chrysomelidae) possess defensive glands? A scanning electron microscopic study

Larvae of the chrysomelid taxon Galerucinae, Sermylini, are known to release a fluid from dorsolateral segmental openings when disturbed. The release of this fluid resembles the discharge of secretion from well-studied exocrine defensive glands in larvae of Chrysomelinae, the putative sister group of Galerucinae. Thus, Sermylini larvae have been named “glanduliferous” ones. However, no comparative analyses of the internal structures of the segmental openings in Sermylini larvae have been available prior to this study. Therefore, segmental larval openings in 10 Sermylini species were investigated by scanning and light microscopy. Two types of segmental openings were detected: (1) the opening is visible as an integumental slit which can be opened and closed by muscles. No specific glandular structures are associated with this slit. (2) The opening is covered internally by a cuticular sac which can be everted to the outside. A cuticular duct of a gland is leading into this sac. Haemolymph is discharged from both types of openings. These structures are discussed with respect to reflex bleeding in other taxa. Furthermore, a common origin of the segmental openings in larvae of Sermylini and the segmental exocrine glands in chrysomeline larvae is critically questioned.     

高剂量生长抑素、奥美拉唑联合止血芳酸治疗急性上消化道出血合并凝血功能障碍患者的临床效果

目的:探讨高剂量生长抑素、奥美拉唑联合止血芳酸治疗急性上消化道出血合并凝血功能障碍患者的临床效果及安全性。方法:选择我院2014年1月~2017年12月收治的92例急性上消化出血合并凝血功能障碍的患者,并按随机数表法将其分为对照组和研究组。对照组予以常规剂量生长抑素、奥美拉唑联合止血芳酸治疗,研究组予以高剂量生长抑素治疗,其余奥美拉唑及止血芳酸用法同对照组。治疗后,比较两组的临床疗效、止血情况、住院时间,治疗前后血常规指标、凝血功能的变化及并发症的发生情况。结果:治疗后,研究组总有效率明显高于对照组[91.30%vs.74.42%](P0.05),而平均止血时间、再止血率及住院时间均明显短于对照组(P0.05);两组白细胞计数(WBC)、部分活化凝血酶原时间(APTT)及凝血酶原时间(PT)均较治疗前明显下降,血红蛋白(Hb)、红细胞计数(RBC)、红细胞压积(Hct)及血小板计数(PLT)均较治疗前明显上升,且研究组以上指标变化较对照组更明显(P0.05)。两组并发症的发生率比较差异均无统计学意义(P0.05)。结论:高剂量生长抑素、奥美拉唑联合止血芳酸治疗急性上消化道出血合并凝血功能障碍的效果明显优于常规剂量生长抑素、奥美拉唑联合止血芳酸治疗,其能够更有效缩短止血时间,避免再出血,且未增加药物不良反应,安全性高。