AIM: To examine the role of Fibrinogen-like protein 2 (fgl2)/fibroleukin in tumor development. Fgl2 has been reported to play a vital role in the pathogenesis in MHV-3 (mouse hepatitis virus) induced fulminant an...AIM: To examine the role of Fibrinogen-like protein 2 (fgl2)/fibroleukin in tumor development. Fgl2 has been reported to play a vital role in the pathogenesis in MHV-3 (mouse hepatitis virus) induced fulminant and severe hepatitis, spontaneous abortion, allo- and xenograft rejection by mediating "immune coagulation".METHODS: Tumor tissues from 133 patients with six types of distinct cancers and the animal tumor tissues from human hepatocellular carcinoma (HCC) model on nude mice (established from high metastasis HCC cell line MHCC97LM6) were obtained. RESULTS: HfgI2 was detected in tumor tissues from 127 out of 133 patients as well as tumor tissues collected from human HCC nude mice. Hfgl2 was highly expressed both in cancer cells and interstitial inflammatory cells including macrophages, NK cells, and CD8^+ T lymphocytes and vascular endothelial cells. HfgI2 mRNA was localized in cells that expressed hfgI2 protein. Fibrin (nogen) colocalization with hfgl2 expression was determined by dual immunohistochemical staining. In vitro, IL-2 and IFN-γ, increased hfgl2 mRNA by 10-100 folds and protein expression in both THP-1 and HUVEC cell lines. One-stage clotting assays demonstrated that THP-1 and HUVEC cells expressing hfgl2 had increased procoagulant activity following cytokines stimulation. CONCLUSION: The hfgI2 contributes to the hypercoagulability in cancer and may induce tumor angiogenesis and metastasis via cytokine induction.展开更多
BACKGROUND Gastric cancer(GC)is a prevalent malignancy with a substantial health burden and high mortality rate,despite advances in prevention,early detection,and treatment.Compared with the global average,Asia,notabl...BACKGROUND Gastric cancer(GC)is a prevalent malignancy with a substantial health burden and high mortality rate,despite advances in prevention,early detection,and treatment.Compared with the global average,Asia,notably China,reports disproportionately high GC incidences.The disease often progresses asymptoma-tically in the early stages,leading to delayed diagnosis and compromised out-comes.Thus,it is crucial to identify early diagnostic biomarkers and enhance treatment strategies to improve patient outcomes and reduce mortality.METHODS Retrospectively analyzed the clinical data of 148 patients with GC treated at the Civil Aviation Shanghai Hospital between December 2022 and December 2023.The associations of coagulation indices-partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),fibrinogen,fibrinogen degradation products(FDP),fasting blood glucose,and D-dimer(D-D)with TNM stage and distant metastasis were examined.RESULTS Prolongation of APTT,PT,and TT was significantly correlated with the GC TNM stage.Hence,abnormal coagulation system activation was closely related to disease progression.Elevated FDP and D-D were significantly associated with distant metastasis in GC(P<0.05),suggesting that increased fibrinolytic activity contributes to increased metastatic risk.CONCLUSION Our Results reveal coagulation indices,FDPs as GC biomarkers,reflecting abnormal coagulation/fibrinolysis,aiding disease progression,metastasis prediction,and helping clinicians assess thrombotic risk for early intervention and personalized treatment plans.展开更多
BACKGROUND:This study aimed to explore the importance of routine coagulation tests for the early detection of sepsis and to quickly identify patients at a high risk of mortality.METHODS:This retrospective single-cente...BACKGROUND:This study aimed to explore the importance of routine coagulation tests for the early detection of sepsis and to quickly identify patients at a high risk of mortality.METHODS:This retrospective single-center study collected data from patients meeting the clinical criteria for systemic inflammatory response syndrome(SIRS) with a confirmed infection source.Patients with coagulation disorders or on medications affecting coagulation were excluded.Patients were divided into sepsis and non-sepsis groups based on a Sequential Organ Failure Assessment(SOFA) score of ≥2.Univariate and multivariate logistic regression identified indicators from routine coagulation tests that predict sepsis.Prognostic roles of coagulation indicators were analyzed within the sepsis group.RESULTS:A total of 512 patients were included,with 396 in the sepsis group and 116 in the non-sepsis group.The predictive factors in the sepsis prediction model encompass fibrin degradation products(FDP),D-dimer,lactate,procalcitonin(PCT) levels and the utilization of mechanical ventilation.Early elevation of FDP and D-dimer levels predicted sepsis onset.The model exhibited an area under the curve(AUC) of 0.943(95% CI:0.923–0.963).In the sepsis group,Cox regression analysis revealed an association between prothrombin time(PT) and in-hospital mortality.CONCLUSION:Abnormal high FDP and D-dimer levels in the early stages of sepsis provide a supplementary method for predicting sepsis.As the disease progresses,prolonged PT in the early stages of sepsis suggests a poor prognosis.展开更多
In this study,synthetic wastewater containing 110μg/L arsenate(As(V)),0-20 mg/L fulvic acid(FA),and 0-12.3 mg/L phosphate was treated with 3 mg/L Fe3+.The mechanisms of FA and phosphate effects on As(V)removal by fer...In this study,synthetic wastewater containing 110μg/L arsenate(As(V)),0-20 mg/L fulvic acid(FA),and 0-12.3 mg/L phosphate was treated with 3 mg/L Fe3+.The mechanisms of FA and phosphate effects on As(V)removal by ferric chloride were determined using 0.22-10μm pore-size filtration,Zetasizer analysis,and in situ flow through cell ATR-FTIR.The results showed that up to 20mg/L FA had almost no effect on the solubility of ferric hydroxide precipitates and adsorption of As(V)by the precipitates.When FA concentration increased from 0 to 20 mg/L,the adsorption of FA led to higher negative zeta potential of the precipitates and the strong electrostatic repulsion between the precipitates decreased the particle size of ferric hydroxide flocs fromlarger than 10μmto smaller than 1μm.In the presence of 5-20 mg/L FA,46%-63%As(V)was adsorbed onto the flocs with particle size in the range of 0.45-1μm.On the other hand,phosphate did not affect the size of ferric hydroxide flocs and significantly increased the dissolved As(V)concentration because it competed with As(V)for adsorption sites on ferric hydroxide precipitates.The addition of 5mg/L cationic organic flocculant significantly reduced the effect of FA on As(V)removal,but did not reduce the effect of phosphate on As(V)removal.The findings of this study will help develop effective arsenic treatment techniques and predict the mobility of arsenic in the environment.展开更多
As part of sewage treatment,coagulation could remove phosphorus from the effluent of the Anaerobic-Anoxic-Oxic-Anoxic(A^(2)OA)biological process.The importance in investigating the influence of coagulation on Anaerobi...As part of sewage treatment,coagulation could remove phosphorus from the effluent of the Anaerobic-Anoxic-Oxic-Anoxic(A^(2)OA)biological process.The importance in investigating the influence of coagulation on Anaerobic-Anoxic-Oxic-Anoxic Membrane Bioreactor(A^(2)OA-MBR)should be emphasized.In this study,systematic optimization of coagulation parameters for greater pollutant removal was conducted in terms of coagulant dosage,coagulation residence time and stirring hydraulic conditions.Coagulation process could remarkably remove turbidity,phosphorus,chemical oxygen demand,humic-like,protein-like and polysaccharide-like substances from secondary effluent and A^(2)OA sludge-liquid mixture.Furthermore,the influence of coagulation on membrane fouling development during the ultrafiltration of secondary effluent and A^(2)OA sludge-liquid mixture was investigated based on optimum coagulation parameters.Coagulation simultaneously reduced reversible membrane fouling and the irreversible one by 86%and 16%,respectively.According to excitation-emission matrix and attenuated total reflection-fourier transform infrared spectra,membrane fouling was primarily influenced by the cake layer,although pore fouling might be aggravated by A^(2)OA processes.Besides,the feasibility of coagulation-assisted A^(2)OA-MBRwas also assessed using hollowfibermembranes.It exhibited excellent potential in alleviatingmembrane fouling,while regular cleaning twice a day was not enough to suppress transmembrane pressure increase during direct domestic wastewater ultrafiltration.Additionally,both polysaccharide-like and protein-like foulants were vital components for membrane fouling during wastewater treatment.展开更多
Gastric cancer(GC)has remained one of the leading causes of cancer-related deaths globally.The development of noninvasive biomarkers in cancer diagnosis and treatment has gained substantial traction in recent years.Re...Gastric cancer(GC)has remained one of the leading causes of cancer-related deaths globally.The development of noninvasive biomarkers in cancer diagnosis and treatment has gained substantial traction in recent years.Recent evidence highlights hypercoagulation as a promising prognostic biomarker,particularly in locally advanced GC(LAGC)who underwent radical resection after neoadjuvant immunochemotherapy(NICT).A recent study by Li et al showed that hypercoagulation is a valuable prognostic indicator for patients with LAGC who have undergone radical resection following NICT.While the study addresses an important clinical issue and provides insightful findings,the present study offered valuable insights;the applicability of these findings was constrained by the retrospective design,the focus on a single center,and the small sample size of the existing studies.Additionally,vital confounders,such as preoperative comorbidities and systemic inflammation,are inadequately addressed.Future studies should focus on prospective multicenter trials,incorporating advanced predictive models such as machine learning algorithms to integrate coagulation markers with other clinical variables for personalized risk stratification.In addition,we are required to validate findings to examine the biological mechanisms correlating hypercoagulation to tumor progression.Integrating machine learning,comprehensive biomarker panels,and real-world data would allow the researchers to have personalized risk stratification,improve predictive accuracy,and optimize clinical decision-making.Finally,A multidisciplinary approach,including lifestyle interventions and imaging modalities,is essential to improve outcomes among patients with GC.展开更多
BACKGROUND Cardiac metastatic tumors(CMTs)are rare yet pose significant medical concerns.Clinical studies on CMT are limited,particularly those involving multicenter data analysis.AIM To systematically analyze the eti...BACKGROUND Cardiac metastatic tumors(CMTs)are rare yet pose significant medical concerns.Clinical studies on CMT are limited,particularly those involving multicenter data analysis.AIM To systematically analyze the etiology,sources,classification,treatment,and prognosis of CMT.METHODS A total of 226 CMT patients from two centers(2013 to 2023)were reviewed,and 153 tumor patients from China Health and Retirement Longitudinal Study were used as controls.The survival rates of 96 CMT patients were tracked through medical records and telephone follow-ups.Logistic regression and survival analyses were conducted to characterize CMT.RESULTS CMTs were predominantly male(67.26%vs 39.47%,P<0.001).Intracardiac metastasis patients had worse heart and coagulation function than pericardial metastasis patients(prothrombin time:13.90 vs 13.30,P=0.002),D-dimer levels(2.16 vs 0.85,P=0.001),B-type natriuretic peptide(BNP)levels(324.00 vs 136.50,P=0.004),and troponin levels(5.35 vs 0.03,P<0.001)).Lung and liver cancers were the predominant primary tumor types in CMT.Patients with lung cancer(76.40%vs 30.77%)and thymoma(7.45%vs 1.54%)exhibited a higher prevalence of pericardial metastasis,while those with liver cancer(35.38%vs 0.62%)showed a higher prevalence of intracardiac metastasis.Overall survival was better for pericardial metastasis than for intracardiac metastasis patients(median survival:419 days vs 129 days,log-rank test P=0.0029).Cox proportional hazards model revealed that advanced age[hazard ratio(HR)=1.034,95%confidence interval(95%CI):1.011-1.057]and higher BNP and troponin levels(HR=1.011,95%CI:1.004-1.018)were associated with worse survival.Surgery significantly improved the survival rate of patients.The median survival time was 275 days for patients who did not undergo surgery and 708 days for those who had surgery(log-rank test P=0.0128)CONCLUSION Clinicians should consider CMT in the male lung or liver cancer patients with cardiac symptoms.Abnormal coagulation,impaired heart function,tumor location,and age are key prognostic factors for CMT.Surgical intervention is the preferred treatment option,as it significantly prolongs median survival.展开更多
Dynamic changes in the physiochemical,structural,and flavor characteristics of ginger-juice milk curd were explored by texture analysis,scanning electron microscopy,rheometry,electronic tongue,and gas chromatography-m...Dynamic changes in the physiochemical,structural,and flavor characteristics of ginger-juice milk curd were explored by texture analysis,scanning electron microscopy,rheometry,electronic tongue,and gas chromatography-mass spectrometry(GC-MS).Protein electrophoresis showed that ginger juice could hydrolyzeαs-,β-,andκ-casein.Curd formation was initiated at 90 s,marked by significant changes in intensity detected via intrinsic fluorescence.The contents of soluble protein and calcium decreased rapidly during coagulation,while the caseinolytic activity,storage moduli,loss moduli,hardness,adhesiveness,and water-holding capacity increased,resulting in a denser gel structure with smaller pores and fewer cavitations as observed by scanning electron microscopy.Electronic tongue analysis indicated that milk could neutralize the astringency and saltiness of ginger juice,rendering the taste of ginger-juice milk curd more akin to that of milk.Approximately 70 volatile components were detected in ginger-juice milk curd.α-Zingiberene,α-curcumene,β-sesquiphellandrene,andβ-bisabolene were the predominant volatile flavor compounds,exhibiting an initial decrease in content followed by stability after 90 s.Decanoic acid,γ-elemene,and caryophyllene were identified as unique volatile compounds after mixing of milk and ginger juice.Understanding the dynamic changes in these characteristics during coagulation holds significant importance for the production of ginger-juice milk curd.展开更多
BACKGROUND Coagulation status is closely related to the progression of malignant tumors.In the era of neoadjuvant immunochemotherapy(NICT),the prognostic utility of coagulation indicators in patients with locally adva...BACKGROUND Coagulation status is closely related to the progression of malignant tumors.In the era of neoadjuvant immunochemotherapy(NICT),the prognostic utility of coagulation indicators in patients with locally advanced gastric cancer(LAGC)undergoing new treatments remains to be determined.AIM To determine whether hypercoagulation is an effective prognostic indicator in patients with LAGC who underwent radical resection after NICT.METHODS A retrospective analysis of clinical data from 104 patients with LAGC,who underwent radical resection after NICT between 2020 and 2023,was performed.Ddimer and fibrinogen concentrations were measured one week before NICT,and again one week before surgery,to analyze the association between these two indicators and their combined indices[non-hypercoagulation(D-dimer and fibrinogen concentrations within the upper limit of normal)vs hypercoagulation(D-dimer or fibrinogen concentrations above the upper limit of normal)]with prognosis.After radical resection,patients were followed-up periodically.The median follow-up duration was 21 months.RESULTS Data collected after NICT revealed that the three-year overall survival(OS)and disease-free survival(DFS)rates the non-hypercoagulation group were significantly better than those in the hypercoagulation group[94.4%vs 78.0%(P=0.019)and 87.0%vs 68.0%(P=0.027),respectively].Multivariate analysis indicated that hypercoagulation after NICT was an independent factor for poor postoperative OS[hazard ratio(HR)4.436,P=0.023]and DFS(HR 2.551,P=0.039).Pre-NICT data demonstrated no statistically significant difference in three-year OS between the non-hypercoagulation and hypercoagulation groups(88.3%vs 84.1%,respectively;P=0.443).CONCLUSION Hypercoagulation after NICT is an effective prognostic indicator in patients with LAGC undergoing radical gastrectomy.展开更多
BACKGROUND Currently,there is a notable lack of reliable studies evaluating the impact of multidisciplinary treatment strategies following transarterial chemoembolization(TACE)on patients with hepatocellular carcinoma...BACKGROUND Currently,there is a notable lack of reliable studies evaluating the impact of multidisciplinary treatment strategies following transarterial chemoembolization(TACE)on patients with hepatocellular carcinoma(HCC),underscoring the urgent need for higher-level research in this area.AIM To investigate the association of multidisciplinary treatment strategies with the immunological,coagulation,and tumor biomarker responses after post-TACE in HCC.METHODS This retrospective analysis included 100 patients with HCC who were categorized based on the treatment approach into the control(patients treated with TACE alone)and experimental groups(patients receiving multidisciplinary treatment strategies post-TACE).Participant characteristics,short-term efficacy,and safety assessment as well as immunological,coagulation,and tumor biomarker res-ponses between the two groups were collected and compared.RESULTS Compared with the control group,the experimental group demonstrated a superior overall response rate,along with an increased fibrinogen,markedly improved immunological biomarker,lower prothrombin time,thrombin time,alpha-fetoprotein,carcinoembryonic antigen,and carbohydrate antigen 199 levels,as well as a decreased abnormal prothrombin incidence,and a lower overall rate of adverse reactions.Notably,no significant difference in the activated partial thromboplastin time and D-dimer levels was observed between the two groups.CONCLUSION Multidisciplinary treatment strategies post-TACE have improved the treatment outcome,the immunological response,and the coagulation function,lowered the tumor biomarker response levels,and reduced the risk of adverse reactions in patients with HCC.展开更多
In recent years,the effect of pulsed magnetic fields on improving the solidification structure of alloys has attracted significant attention.A GH4738 nickel-based alloy smelted using a self-designed 20-kg electromagne...In recent years,the effect of pulsed magnetic fields on improving the solidification structure of alloys has attracted significant attention.A GH4738 nickel-based alloy smelted using a self-designed 20-kg electromagnetic casting system was taken as the research object.Finite element software was used to numerically simulate the magnetic field intensity,distribution,and temperature field of the casting device.The effect of the pulsed magnetic field on the solidification process of the GH4738 alloy was studied by means of low-magnification microstructural analysis.The measured magnetic field shows that when the duty cycle is 20%,the pulse frequency is 50 Hz,the output current is in the range of 150–250 A,and the peak magnetic field intensity of the crucible center is 68–116 mT.The crucible temperature is heated to 600℃and the melt center solidification time is 12.844 s.The microstructural analysis of the ingot shows that its shrinkage hole is reduced from 130 to 100 mm,and the equiaxed crystal area is increased from 2275 to 3150 mm^(2).The solidification angle of the dendrite is changed under the action of the pulsed magnetic field,and the tilt angle is 45°.The results show that the pulsed magnetic field promotes the primary crystal core of the GH4738 alloy,improves the nucleation rate of the melt,reduces the size difference of the solidification structure between the center and the edge of the ingot,and improves the uniformity of the solidification structure.展开更多
This letter to the editor involves the article published in the World Journal of Gastrointestinal Oncology.Bone metastasis(BM)in gastric cancer(GC)is uncommon but can be prevalent in autopsy studies.BM significantly i...This letter to the editor involves the article published in the World Journal of Gastrointestinal Oncology.Bone metastasis(BM)in gastric cancer(GC)is uncommon but can be prevalent in autopsy studies.BM significantly impairs quality of life and is frequently underdiagnosed,as sensitive diagnostic tests are only performed after symptoms occur.Imaging is crucial for the diagnosis of BM but is not routinely used for screening and is expensive.Examining laboratory risk factors for BM in GC patients using multivariate analysis could be a more effective approach.展开更多
To the Editor,Systemic lupus erythematosus(SLE)is an autoimmune disease characterized by multisystem involvement.In addition to butterfly erythema,photosensitivity,arthritis,and other clinical manifestations,SLE can a...To the Editor,Systemic lupus erythematosus(SLE)is an autoimmune disease characterized by multisystem involvement.In addition to butterfly erythema,photosensitivity,arthritis,and other clinical manifestations,SLE can also result in hematological complications,such as coagulopathy.Acquired hemophilia has been documented in patients with SLE,attributed to the presence of inhibitors against coagulation factors in the circulating blood.1 Furthermore,deficiency of factor XII(FXII)has been reported in patient with SLE in the absence of FXII inhibitors.2,3 However,there have been no reports of a deficiency of FIX without the presence of FIX inhibitors in patients with SLE.In this report,we present a case of a patient with SLE who exhibited recurrent mucosal bleeding attributed to reduced activity of FIX without detectable inhibitors.展开更多
Dear Editor,Crimean–Congo hemorrhagic fever(CCHF),caused by the CCHF virus(CCHFV),is a severe tick-borne illness with a wide geographical distribution,posing a significant threat with case fatality rates ranging from...Dear Editor,Crimean–Congo hemorrhagic fever(CCHF),caused by the CCHF virus(CCHFV),is a severe tick-borne illness with a wide geographical distribution,posing a significant threat with case fatality rates ranging from 5%to 70%(Hawman and Feldmann,2023).Due to the lack of approved vaccines and therapeutics,the World Health Organization(WHO)has listed CCHF as one of the priority diseases(Semper et al.,2024).CCHF initially presents as a nonspecific febrile illness,characterized by fever,malaise,myalgia,and nausea,which can rapidly progress to hemorrhagic disease.The hemorrhagic stage is particularly pronounced in severe cases,with rapid progression to disseminated intravascular coagulation(DIC),overt bleeding,kidney or liver failure,and shock(Frank et al.,2024).Up to date,there is an absence of a suitable animal model that can accurately mimic the coagulopathy and bleeding associated with CCHFV infection.Consequently,our understanding of the pathogenic mechanisms underlying these conditions remains limited(Rodriguez et al.,2022).展开更多
The accurate and timely detection of biochemical coagulation indicators is pivotal in pulmonary and critical care medicine.Despite their reliability,traditional laboratories often lag in terms of rapid diagnosis.Point...The accurate and timely detection of biochemical coagulation indicators is pivotal in pulmonary and critical care medicine.Despite their reliability,traditional laboratories often lag in terms of rapid diagnosis.Point-of-care testing(POCT)has emerged as a promising alternative,which is awaiting rigorous validation.We assessed 226 samples from patients at the First Affiliated Hospital of Guangzhou Medical University using a Beckman Coulter AU5821 and a PUSHKANG POCT Biochemistry Analyzer MS100.Furthermore,350 samples were evaluated with a Stago coagulation analyzer STAR MAX and a PUSHKANG POCT Coagulation Analyzer MC100.Metrics included thirteen biochemical indexes,such as albumin,and five coagulation indices,such as prothrombin time.Comparisons were drawn against the PUSHKANG POCT analyzer.Bland-Altman plots(MS100:0.8206-0.9995;MC100:0.8318-0.9911)evinced significant consistency between methodologies.Spearman correlation pinpointed a potent linear association between conventional devices and the PUSHKANG POCT analyzer,further underscored by a robust correlation coefficient(MS100:0.713-0.949;MC100:0.593-0.950).The PUSHKANG POCT was validated as a dependable tool for serum and whole blood biochemical and coagulation diagnostics.This emphasizes its prospective clinical efficacy,offering clinicians a swift diagnostic tool and heralding a new era of enhanced patient care outcomes.展开更多
Purpose: To compare the effects and side-effects of fondaparinux sodium and low molecular weight heparin in patients with hypercoagulability accompanied with traumatic infection. Methods: Thirty-six patients with po...Purpose: To compare the effects and side-effects of fondaparinux sodium and low molecular weight heparin in patients with hypercoagulability accompanied with traumatic infection. Methods: Thirty-six patients with post-traumatic infections in our hospital intensive care center were diagnosed with hypercoagulability from February 2012 to February 2013. These patients were randomly divided into 2 groups. In group F (18 patients), the patients were treated with fondaparinux sodium, 2.5 rag, 1/d for 11 d. In group L (18 patients), the patients were treated with low molecular weight heparin, 4100 U, 1/12 h for 11 d. The incidence of deep vein thrombosis, bleeding events and multiple organ dysfunction syndrome (MODS) and mortality of two groups after anticoagulation therapy were analyzed. Fibrinogen, D-dimer level and activity of antithrombin Ⅲ were measured by the coagulation analyzer. Results: The incidence of deep vein thrombosis, MODS incidence and mortality were not significantly different between the two groups. The rate of bleeding evens in group F was lower than group L (p 〈 0.05). Antithrombin Ⅲ got an upward trend after anticoagulant therapy, in which it was higher in group F than in group L on the 5th d and llth d (p 〈 0.05). Fibrinogen levels were gradually increased, and there was no significant difference between two groups (p 〉 0.05). D-dimer was significantly decreased after anticoagulant therapy for 5 d (p 〈 0.01 ), and there were significant differences between two groups on the 5th d and 7th d (p 〈 0.05). It showed no significant difference on the llth d (p 〉 0.05). Conclusion: Fondaparinux sodium and low molecular weight heparin can effectively improve coagulopathy in patients with traumatic infection. Compared with low molecular weight heparin, fondaparinux sodium may reduce the risk of bleeding events in patients with hypercoagulability accompanied by traumatic infection.展开更多
Objective To investigate the pathogenesis of thromboembolism in patients with mitral stenosis in a pre-thrombotic state.Methods The biochemical markers’ levels in plasma for platelet activity [soluble P-selectin (G...Objective To investigate the pathogenesis of thromboembolism in patients with mitral stenosis in a pre-thrombotic state.Methods The biochemical markers’ levels in plasma for platelet activity [soluble P-selectin (GMP-140)],states of thrombin generation [antithrombin Ⅲ (AT Ⅲ) and protein C (PC)],fibrinolysis [D-dimer (DD), plasminogen activator inhibitor 1 (PAI-1),tissue plasminogen activator (t-PA) and FDP] and von Willebrand factor (vWF) were determined from blood specimens obtained from the femoral veins and arteries and the right and left atria of 43 consecutive patients (20 with atrial fibrillation and 23 with sinus rhythm) with mitral stenosis (MS),undergoing percutaneous mitral valvuloplasty. The same parameters were compared with those of 15 control subjects,who had no detectable heart disease,but with paroxysmal supraventricular tachycardia undergoing radiofrequency catheter ablation of the left accessory pathway through a transseptal passage. Results Blood from the left atrium contained an excessive amount of platelet activity,thrombin generation and fibrinolysis compared with the blood from the right atrium,and the femoral veins and arteries. However blood from the right atrium was much lower in these activities when compared with those from the left atrium,and the femoral veins and arteries in both groups. Compared with those in the control subjects, GMP-140 in the left atrium was significantly higher ( P <0.05) and AT Ⅲ was significantly lower ( P <0.05) in patients with MS. Compared with the patients with MS and spontaneous left atrial echocontrast (LASEC)≤1,the patients with MS and LASEC≥2 had significantly higher levels of GMP-140 in plasma ( P <0.05),and significantly lower levels of AT Ⅲ ( P <0.05) and PC ( P <0.01) levels in the left atrium. However, there were no significant differences between patients with atrial fibrillation and those with sinus rhythm regarding amounts of plasma coagulation markers in the left atrium. Univariate regression analysis revealed that LASEC was negatively correlated with plasma levels of blood from the left atria in the patients with MS. Conclusion Coagulability is increased in the left atria of patients with MS and is positively correlated with LASEC.展开更多
The coagulation process is a widely applied technology in water and wastewater treatment.Novel composite polyferric mag-nesium-silicate-sulfate(PFMS)coagulants were synthesized using Na_(2)SiO_(3)·9H_(2)O,Fe_(2)(...The coagulation process is a widely applied technology in water and wastewater treatment.Novel composite polyferric mag-nesium-silicate-sulfate(PFMS)coagulants were synthesized using Na_(2)SiO_(3)·9H_(2)O,Fe_(2)(SO_(4))_(3),and MgSO_(4) as raw materials in this paper.The effects of aging time,Fe:Si:Mg,and OH:M molar ratios(M represents the metal ions)on the coagulation performance of the as-pre-pared PFMS were systematically investigated to obtain optimum coagulants.The results showed that PFMS coagulant exhibited good co-agulation properties in the treatment of simulated humic acid-kaolin surface water and reactive dye wastewater.When the molar ratio was controlled at Fe:Si:Mg=2:2:1 and OH:M=0.32,the obtained PFMS presented excellent stability and a high coagulation efficiency.The removal efficiency of ultraviolet UV254 was 99.81%,and the residual turbidity of the surface water reached 0.56 NTU at a dosage of 30 mg·L^(-1).After standing the coagulant for 120 d in the laboratory,the removal efficiency of UV254 and residual turbidity of the surface wa-ter were 88.12%and 0.68 NTU,respectively,which accord with the surface water treatment requirements.In addition,the coagulation performance in the treatment of reactive dye wastewater was greatly improved by combining the advantages of magnesium and iron salts.Compared with polyferric silicate-sulfate(PFS)and polymagnesium silicate-sulfate(PMS),the PFMS coagulant played a better decolor-ization role within the pH range of 7-13.展开更多
Objective Coagulation abnormalities are common and prognostically significant in intensive care units(ICUs)and are associated with increased mortality.This study aimed to explore the association between the levels of ...Objective Coagulation abnormalities are common and prognostically significant in intensive care units(ICUs)and are associated with increased mortality.This study aimed to explore the association between the levels of coagulation markers and the risk of mortality among ICU patients with coagulation abnormalities.Methods This retrospective study investigated patients with coagulation abnormalities in the ICU between January 2021 and December 2022.The initial point for detecting hemostatic biomarkers due to clinical assessment of coagulation abnormalities was designated day 0.Patients were followed up for 28 days,and multivariate logistic regression analysis was utilized to identify risk factors for mortality.Results Of the 451 patients analyzed,115 died,and 336 were alive at the end of the 28-day period.Multivariate analysis revealed that elevated thrombin-antithrombin complex(TAT),tissue plasminogen activator inhibitor complex(tPAIC),prolonged prothrombin time,and thrombocytopenia were independent risk factors for mortality.For nonovert disseminated intravascular coagulation(DIC)patients,older age and thrombocytopenia were associated with increased risks of mortality,whereas elevated levels of plasminα2-plasmin inhibitor complex(PIC)were found to be independent predictors of survival.In patients with overt DIC,elevated levels of tPAIC were independently associated with increased risks of mortality.Nevertheless,thrombocytopenia was independently associated with increased risks of mortality in patients with pre-DIC.Conclusion Coagulation markers such as the TAT,tPAIC,PIC,and platelet count were significantly associated with mortality,underscoring the importance of maintaining a balance between coagulation and fibrinolysis.These findings highlight the potential for targeted therapeutic interventions based on specific coagulation markers to improve patient outcomes.展开更多
BACKGROUND:Disseminated intravascular coagulation(DIC)is associated with increased mortality in sepsis patients.In this study,we aimed to assess the clinical ability of sepsis-induced coagulopathy(SIC)and sepsis-assoc...BACKGROUND:Disseminated intravascular coagulation(DIC)is associated with increased mortality in sepsis patients.In this study,we aimed to assess the clinical ability of sepsis-induced coagulopathy(SIC)and sepsis-associated coagulopathy(SAC)criteria in identifying overt-DIC and preDIC status in sepsis patients.METHODS:Data from 419 sepsis patients were retrospectively collected from July 2018 to December 2022.The performances of the SIC and SAC were assessed to identify overt-DIC on days 1,3,7,or 14.The SIC status or SIC score on day 1,the SAC status or SAC score on day 1,and the sum of the SIC or SAC scores on days 1 and 3 were compared in terms of their ability to identify pre-DIC.The SIC or SAC status on day 1 was evaluated as a pre-DIC indicator for anticoagulant initiation.RESULTS:On day 1,the incidences of coagulopathy according to overt-DIC,SIC and SAC criteria were 11.7%,22.0%and 31.5%,respectively.The specificity of SIC for identifying overt-DIC was significantly higher than that of the SAC criteria from day 1 to day 14(P<0.05).On day 1,the SIC score with a cut-off value>3 had a significantly higher sensitivity(72.00%)and area under the curve(AUC)(0.69)in identifying pre-DIC than did the SIC or SAC status(sensitivity:SIC status 44.00%,SAC status 52.00%;AUC:SIC status 0.62,SAC status 0.61).The sum of the SIC scores on days 1 and 3 had a higher AUC value for identifying the pre-DIC state than that of SAC(0.79 vs.0.69,P<0.001).Favorable effects of anticoagulant therapy were observed in SIC(adjusted hazard ratio[HR]=0.216,95%confidence interval[95%CI]:0.060–0.783,P=0.018)and SAC(adjusted HR=0.146,95%CI:0.041–0.513,P=0.003).CONCLUSION:The SIC and SAC seem to be valuable for predicting overt-DIC.The sum of SIC scores on days 1 and 3 has the potential to help identify pre-DIC.展开更多
基金The Natural Science Foundation of China,NSFC (30672380,30571643)National Key Basic Research Program of China (2007CB512900,2005CB522901,2005CB522507)11th Five-Year Plan Key Project (2006BAI05A07)
文摘AIM: To examine the role of Fibrinogen-like protein 2 (fgl2)/fibroleukin in tumor development. Fgl2 has been reported to play a vital role in the pathogenesis in MHV-3 (mouse hepatitis virus) induced fulminant and severe hepatitis, spontaneous abortion, allo- and xenograft rejection by mediating "immune coagulation".METHODS: Tumor tissues from 133 patients with six types of distinct cancers and the animal tumor tissues from human hepatocellular carcinoma (HCC) model on nude mice (established from high metastasis HCC cell line MHCC97LM6) were obtained. RESULTS: HfgI2 was detected in tumor tissues from 127 out of 133 patients as well as tumor tissues collected from human HCC nude mice. Hfgl2 was highly expressed both in cancer cells and interstitial inflammatory cells including macrophages, NK cells, and CD8^+ T lymphocytes and vascular endothelial cells. HfgI2 mRNA was localized in cells that expressed hfgI2 protein. Fibrin (nogen) colocalization with hfgl2 expression was determined by dual immunohistochemical staining. In vitro, IL-2 and IFN-γ, increased hfgl2 mRNA by 10-100 folds and protein expression in both THP-1 and HUVEC cell lines. One-stage clotting assays demonstrated that THP-1 and HUVEC cells expressing hfgl2 had increased procoagulant activity following cytokines stimulation. CONCLUSION: The hfgI2 contributes to the hypercoagulability in cancer and may induce tumor angiogenesis and metastasis via cytokine induction.
文摘BACKGROUND Gastric cancer(GC)is a prevalent malignancy with a substantial health burden and high mortality rate,despite advances in prevention,early detection,and treatment.Compared with the global average,Asia,notably China,reports disproportionately high GC incidences.The disease often progresses asymptoma-tically in the early stages,leading to delayed diagnosis and compromised out-comes.Thus,it is crucial to identify early diagnostic biomarkers and enhance treatment strategies to improve patient outcomes and reduce mortality.METHODS Retrospectively analyzed the clinical data of 148 patients with GC treated at the Civil Aviation Shanghai Hospital between December 2022 and December 2023.The associations of coagulation indices-partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),fibrinogen,fibrinogen degradation products(FDP),fasting blood glucose,and D-dimer(D-D)with TNM stage and distant metastasis were examined.RESULTS Prolongation of APTT,PT,and TT was significantly correlated with the GC TNM stage.Hence,abnormal coagulation system activation was closely related to disease progression.Elevated FDP and D-D were significantly associated with distant metastasis in GC(P<0.05),suggesting that increased fibrinolytic activity contributes to increased metastatic risk.CONCLUSION Our Results reveal coagulation indices,FDPs as GC biomarkers,reflecting abnormal coagulation/fibrinolysis,aiding disease progression,metastasis prediction,and helping clinicians assess thrombotic risk for early intervention and personalized treatment plans.
基金supported by the Science and Technology Commission of Shanghai Municipality (grant no.22Y11900300)China Primary Health Care Foundation (grant no.MTP2022A0132)Project of Shanghai Administration of Traditional Chinese Medicine (ZXXT-202213)to EQM and LM。
文摘BACKGROUND:This study aimed to explore the importance of routine coagulation tests for the early detection of sepsis and to quickly identify patients at a high risk of mortality.METHODS:This retrospective single-center study collected data from patients meeting the clinical criteria for systemic inflammatory response syndrome(SIRS) with a confirmed infection source.Patients with coagulation disorders or on medications affecting coagulation were excluded.Patients were divided into sepsis and non-sepsis groups based on a Sequential Organ Failure Assessment(SOFA) score of ≥2.Univariate and multivariate logistic regression identified indicators from routine coagulation tests that predict sepsis.Prognostic roles of coagulation indicators were analyzed within the sepsis group.RESULTS:A total of 512 patients were included,with 396 in the sepsis group and 116 in the non-sepsis group.The predictive factors in the sepsis prediction model encompass fibrin degradation products(FDP),D-dimer,lactate,procalcitonin(PCT) levels and the utilization of mechanical ventilation.Early elevation of FDP and D-dimer levels predicted sepsis onset.The model exhibited an area under the curve(AUC) of 0.943(95% CI:0.923–0.963).In the sepsis group,Cox regression analysis revealed an association between prothrombin time(PT) and in-hospital mortality.CONCLUSION:Abnormal high FDP and D-dimer levels in the early stages of sepsis provide a supplementary method for predicting sepsis.As the disease progresses,prolonged PT in the early stages of sepsis suggests a poor prognosis.
基金financially supported by the New Jersey Department of Environmental ProtectionUS EPA。
文摘In this study,synthetic wastewater containing 110μg/L arsenate(As(V)),0-20 mg/L fulvic acid(FA),and 0-12.3 mg/L phosphate was treated with 3 mg/L Fe3+.The mechanisms of FA and phosphate effects on As(V)removal by ferric chloride were determined using 0.22-10μm pore-size filtration,Zetasizer analysis,and in situ flow through cell ATR-FTIR.The results showed that up to 20mg/L FA had almost no effect on the solubility of ferric hydroxide precipitates and adsorption of As(V)by the precipitates.When FA concentration increased from 0 to 20 mg/L,the adsorption of FA led to higher negative zeta potential of the precipitates and the strong electrostatic repulsion between the precipitates decreased the particle size of ferric hydroxide flocs fromlarger than 10μmto smaller than 1μm.In the presence of 5-20 mg/L FA,46%-63%As(V)was adsorbed onto the flocs with particle size in the range of 0.45-1μm.On the other hand,phosphate did not affect the size of ferric hydroxide flocs and significantly increased the dissolved As(V)concentration because it competed with As(V)for adsorption sites on ferric hydroxide precipitates.The addition of 5mg/L cationic organic flocculant significantly reduced the effect of FA on As(V)removal,but did not reduce the effect of phosphate on As(V)removal.The findings of this study will help develop effective arsenic treatment techniques and predict the mobility of arsenic in the environment.
基金supported by the National Natural Science Foundation of China(Nos.52170070,52400022 and 52200088)the Youth S&T Talent Support Programme of Guangdong Provincial Association for Science and Technology(GDSTA)(No.SKXRC202406)+1 种基金China Postdoctoral Science Foundation(No.2023M740754)“One hundred Youth”Science and Technology Plan,Guangdong University of Technology,China(No.263113906).
文摘As part of sewage treatment,coagulation could remove phosphorus from the effluent of the Anaerobic-Anoxic-Oxic-Anoxic(A^(2)OA)biological process.The importance in investigating the influence of coagulation on Anaerobic-Anoxic-Oxic-Anoxic Membrane Bioreactor(A^(2)OA-MBR)should be emphasized.In this study,systematic optimization of coagulation parameters for greater pollutant removal was conducted in terms of coagulant dosage,coagulation residence time and stirring hydraulic conditions.Coagulation process could remarkably remove turbidity,phosphorus,chemical oxygen demand,humic-like,protein-like and polysaccharide-like substances from secondary effluent and A^(2)OA sludge-liquid mixture.Furthermore,the influence of coagulation on membrane fouling development during the ultrafiltration of secondary effluent and A^(2)OA sludge-liquid mixture was investigated based on optimum coagulation parameters.Coagulation simultaneously reduced reversible membrane fouling and the irreversible one by 86%and 16%,respectively.According to excitation-emission matrix and attenuated total reflection-fourier transform infrared spectra,membrane fouling was primarily influenced by the cake layer,although pore fouling might be aggravated by A^(2)OA processes.Besides,the feasibility of coagulation-assisted A^(2)OA-MBRwas also assessed using hollowfibermembranes.It exhibited excellent potential in alleviatingmembrane fouling,while regular cleaning twice a day was not enough to suppress transmembrane pressure increase during direct domestic wastewater ultrafiltration.Additionally,both polysaccharide-like and protein-like foulants were vital components for membrane fouling during wastewater treatment.
文摘Gastric cancer(GC)has remained one of the leading causes of cancer-related deaths globally.The development of noninvasive biomarkers in cancer diagnosis and treatment has gained substantial traction in recent years.Recent evidence highlights hypercoagulation as a promising prognostic biomarker,particularly in locally advanced GC(LAGC)who underwent radical resection after neoadjuvant immunochemotherapy(NICT).A recent study by Li et al showed that hypercoagulation is a valuable prognostic indicator for patients with LAGC who have undergone radical resection following NICT.While the study addresses an important clinical issue and provides insightful findings,the present study offered valuable insights;the applicability of these findings was constrained by the retrospective design,the focus on a single center,and the small sample size of the existing studies.Additionally,vital confounders,such as preoperative comorbidities and systemic inflammation,are inadequately addressed.Future studies should focus on prospective multicenter trials,incorporating advanced predictive models such as machine learning algorithms to integrate coagulation markers with other clinical variables for personalized risk stratification.In addition,we are required to validate findings to examine the biological mechanisms correlating hypercoagulation to tumor progression.Integrating machine learning,comprehensive biomarker panels,and real-world data would allow the researchers to have personalized risk stratification,improve predictive accuracy,and optimize clinical decision-making.Finally,A multidisciplinary approach,including lifestyle interventions and imaging modalities,is essential to improve outcomes among patients with GC.
文摘BACKGROUND Cardiac metastatic tumors(CMTs)are rare yet pose significant medical concerns.Clinical studies on CMT are limited,particularly those involving multicenter data analysis.AIM To systematically analyze the etiology,sources,classification,treatment,and prognosis of CMT.METHODS A total of 226 CMT patients from two centers(2013 to 2023)were reviewed,and 153 tumor patients from China Health and Retirement Longitudinal Study were used as controls.The survival rates of 96 CMT patients were tracked through medical records and telephone follow-ups.Logistic regression and survival analyses were conducted to characterize CMT.RESULTS CMTs were predominantly male(67.26%vs 39.47%,P<0.001).Intracardiac metastasis patients had worse heart and coagulation function than pericardial metastasis patients(prothrombin time:13.90 vs 13.30,P=0.002),D-dimer levels(2.16 vs 0.85,P=0.001),B-type natriuretic peptide(BNP)levels(324.00 vs 136.50,P=0.004),and troponin levels(5.35 vs 0.03,P<0.001)).Lung and liver cancers were the predominant primary tumor types in CMT.Patients with lung cancer(76.40%vs 30.77%)and thymoma(7.45%vs 1.54%)exhibited a higher prevalence of pericardial metastasis,while those with liver cancer(35.38%vs 0.62%)showed a higher prevalence of intracardiac metastasis.Overall survival was better for pericardial metastasis than for intracardiac metastasis patients(median survival:419 days vs 129 days,log-rank test P=0.0029).Cox proportional hazards model revealed that advanced age[hazard ratio(HR)=1.034,95%confidence interval(95%CI):1.011-1.057]and higher BNP and troponin levels(HR=1.011,95%CI:1.004-1.018)were associated with worse survival.Surgery significantly improved the survival rate of patients.The median survival time was 275 days for patients who did not undergo surgery and 708 days for those who had surgery(log-rank test P=0.0128)CONCLUSION Clinicians should consider CMT in the male lung or liver cancer patients with cardiac symptoms.Abnormal coagulation,impaired heart function,tumor location,and age are key prognostic factors for CMT.Surgical intervention is the preferred treatment option,as it significantly prolongs median survival.
基金supported by the Huzhou Science and Technology Plan Project(No.2022GZ56)the Education Department of Zhejiang Province Scientific Research Project(No.Y202248484),China.
文摘Dynamic changes in the physiochemical,structural,and flavor characteristics of ginger-juice milk curd were explored by texture analysis,scanning electron microscopy,rheometry,electronic tongue,and gas chromatography-mass spectrometry(GC-MS).Protein electrophoresis showed that ginger juice could hydrolyzeαs-,β-,andκ-casein.Curd formation was initiated at 90 s,marked by significant changes in intensity detected via intrinsic fluorescence.The contents of soluble protein and calcium decreased rapidly during coagulation,while the caseinolytic activity,storage moduli,loss moduli,hardness,adhesiveness,and water-holding capacity increased,resulting in a denser gel structure with smaller pores and fewer cavitations as observed by scanning electron microscopy.Electronic tongue analysis indicated that milk could neutralize the astringency and saltiness of ginger juice,rendering the taste of ginger-juice milk curd more akin to that of milk.Approximately 70 volatile components were detected in ginger-juice milk curd.α-Zingiberene,α-curcumene,β-sesquiphellandrene,andβ-bisabolene were the predominant volatile flavor compounds,exhibiting an initial decrease in content followed by stability after 90 s.Decanoic acid,γ-elemene,and caryophyllene were identified as unique volatile compounds after mixing of milk and ginger juice.Understanding the dynamic changes in these characteristics during coagulation holds significant importance for the production of ginger-juice milk curd.
基金Natural Science Foundation of Hubei Province of China,No.2024AFB655Key Research and Development Program of Hubei Province of China,No.2021BCA116National Natural Science Foundation of China,No.82072736,No.82003205,No.
文摘BACKGROUND Coagulation status is closely related to the progression of malignant tumors.In the era of neoadjuvant immunochemotherapy(NICT),the prognostic utility of coagulation indicators in patients with locally advanced gastric cancer(LAGC)undergoing new treatments remains to be determined.AIM To determine whether hypercoagulation is an effective prognostic indicator in patients with LAGC who underwent radical resection after NICT.METHODS A retrospective analysis of clinical data from 104 patients with LAGC,who underwent radical resection after NICT between 2020 and 2023,was performed.Ddimer and fibrinogen concentrations were measured one week before NICT,and again one week before surgery,to analyze the association between these two indicators and their combined indices[non-hypercoagulation(D-dimer and fibrinogen concentrations within the upper limit of normal)vs hypercoagulation(D-dimer or fibrinogen concentrations above the upper limit of normal)]with prognosis.After radical resection,patients were followed-up periodically.The median follow-up duration was 21 months.RESULTS Data collected after NICT revealed that the three-year overall survival(OS)and disease-free survival(DFS)rates the non-hypercoagulation group were significantly better than those in the hypercoagulation group[94.4%vs 78.0%(P=0.019)and 87.0%vs 68.0%(P=0.027),respectively].Multivariate analysis indicated that hypercoagulation after NICT was an independent factor for poor postoperative OS[hazard ratio(HR)4.436,P=0.023]and DFS(HR 2.551,P=0.039).Pre-NICT data demonstrated no statistically significant difference in three-year OS between the non-hypercoagulation and hypercoagulation groups(88.3%vs 84.1%,respectively;P=0.443).CONCLUSION Hypercoagulation after NICT is an effective prognostic indicator in patients with LAGC undergoing radical gastrectomy.
文摘BACKGROUND Currently,there is a notable lack of reliable studies evaluating the impact of multidisciplinary treatment strategies following transarterial chemoembolization(TACE)on patients with hepatocellular carcinoma(HCC),underscoring the urgent need for higher-level research in this area.AIM To investigate the association of multidisciplinary treatment strategies with the immunological,coagulation,and tumor biomarker responses after post-TACE in HCC.METHODS This retrospective analysis included 100 patients with HCC who were categorized based on the treatment approach into the control(patients treated with TACE alone)and experimental groups(patients receiving multidisciplinary treatment strategies post-TACE).Participant characteristics,short-term efficacy,and safety assessment as well as immunological,coagulation,and tumor biomarker res-ponses between the two groups were collected and compared.RESULTS Compared with the control group,the experimental group demonstrated a superior overall response rate,along with an increased fibrinogen,markedly improved immunological biomarker,lower prothrombin time,thrombin time,alpha-fetoprotein,carcinoembryonic antigen,and carbohydrate antigen 199 levels,as well as a decreased abnormal prothrombin incidence,and a lower overall rate of adverse reactions.Notably,no significant difference in the activated partial thromboplastin time and D-dimer levels was observed between the two groups.CONCLUSION Multidisciplinary treatment strategies post-TACE have improved the treatment outcome,the immunological response,and the coagulation function,lowered the tumor biomarker response levels,and reduced the risk of adverse reactions in patients with HCC.
基金supported by National Natural Science Foundation of China(No.52074092)the Fundamental Research Funds for Inner Mongolia University of Science&Technology(No.2023QNJS007)+1 种基金Program for Young Talents of Science and Technology in Universities of Inner Mongolia Autonomous Region(No.NJYT23115)the Inner Mongolia Natural Science Foundation(No.2022MS05039).
文摘In recent years,the effect of pulsed magnetic fields on improving the solidification structure of alloys has attracted significant attention.A GH4738 nickel-based alloy smelted using a self-designed 20-kg electromagnetic casting system was taken as the research object.Finite element software was used to numerically simulate the magnetic field intensity,distribution,and temperature field of the casting device.The effect of the pulsed magnetic field on the solidification process of the GH4738 alloy was studied by means of low-magnification microstructural analysis.The measured magnetic field shows that when the duty cycle is 20%,the pulse frequency is 50 Hz,the output current is in the range of 150–250 A,and the peak magnetic field intensity of the crucible center is 68–116 mT.The crucible temperature is heated to 600℃and the melt center solidification time is 12.844 s.The microstructural analysis of the ingot shows that its shrinkage hole is reduced from 130 to 100 mm,and the equiaxed crystal area is increased from 2275 to 3150 mm^(2).The solidification angle of the dendrite is changed under the action of the pulsed magnetic field,and the tilt angle is 45°.The results show that the pulsed magnetic field promotes the primary crystal core of the GH4738 alloy,improves the nucleation rate of the melt,reduces the size difference of the solidification structure between the center and the edge of the ingot,and improves the uniformity of the solidification structure.
文摘This letter to the editor involves the article published in the World Journal of Gastrointestinal Oncology.Bone metastasis(BM)in gastric cancer(GC)is uncommon but can be prevalent in autopsy studies.BM significantly impairs quality of life and is frequently underdiagnosed,as sensitive diagnostic tests are only performed after symptoms occur.Imaging is crucial for the diagnosis of BM but is not routinely used for screening and is expensive.Examining laboratory risk factors for BM in GC patients using multivariate analysis could be a more effective approach.
基金supported by a grant from Peking University Shougang Hospital Research Funds,Grant/Award Number:SGYYZ202403.
文摘To the Editor,Systemic lupus erythematosus(SLE)is an autoimmune disease characterized by multisystem involvement.In addition to butterfly erythema,photosensitivity,arthritis,and other clinical manifestations,SLE can also result in hematological complications,such as coagulopathy.Acquired hemophilia has been documented in patients with SLE,attributed to the presence of inhibitors against coagulation factors in the circulating blood.1 Furthermore,deficiency of factor XII(FXII)has been reported in patient with SLE in the absence of FXII inhibitors.2,3 However,there have been no reports of a deficiency of FIX without the presence of FIX inhibitors in patients with SLE.In this report,we present a case of a patient with SLE who exhibited recurrent mucosal bleeding attributed to reduced activity of FIX without detectable inhibitors.
基金supported in part by grants from the Strategic Priority Research Program of the Chinese Academy of Sciences(XDB0490000 to Z.H.)National Key Research and Development Program(2021YFF0702002 to J.L.,2022YFC2303300 to Z.H.,and 2023YFC2305900 to M.W.)+3 种基金“Youth Commando”project(2023QNTJ-02 TO J.L.)Key Project(2024JZZD-02 to Z.H.)of State Key Laboratory of Virology and BiosafetyWuhan Institute of Virology,the National Natural Science Foundation of China(U22A20336 to Z.H.and Y.Z.)Wuhan Natural Science Foundation(202404071010067 to M.W.and 202404071010068 to J.L.).
文摘Dear Editor,Crimean–Congo hemorrhagic fever(CCHF),caused by the CCHF virus(CCHFV),is a severe tick-borne illness with a wide geographical distribution,posing a significant threat with case fatality rates ranging from 5%to 70%(Hawman and Feldmann,2023).Due to the lack of approved vaccines and therapeutics,the World Health Organization(WHO)has listed CCHF as one of the priority diseases(Semper et al.,2024).CCHF initially presents as a nonspecific febrile illness,characterized by fever,malaise,myalgia,and nausea,which can rapidly progress to hemorrhagic disease.The hemorrhagic stage is particularly pronounced in severe cases,with rapid progression to disseminated intravascular coagulation(DIC),overt bleeding,kidney or liver failure,and shock(Frank et al.,2024).Up to date,there is an absence of a suitable animal model that can accurately mimic the coagulopathy and bleeding associated with CCHFV infection.Consequently,our understanding of the pathogenic mechanisms underlying these conditions remains limited(Rodriguez et al.,2022).
基金supported by the National Natural Science Foundation of China(No.82302607)the Guangdong Basic and Applied Basic Research Foundation(Nos.2022A1515110555 and 2023A1515010932)+3 种基金the State Key Laboratory of Respiratory Disease(No.SKLRD-Z-202410)the Precision Medicine Joint Foundation of Basic and Applied Basic Research Foundation of Guangdong Province(No.2021B1515230008)the Independent Project of Guangdong-Hong Kong-Macao Joint Laboratory for Respiratory Infectious Diseases(No.GHMJLRID-Z-202102)the Guangdong Zhong Nanshan Medical Foundation(No.ZNSXS-20220015).
文摘The accurate and timely detection of biochemical coagulation indicators is pivotal in pulmonary and critical care medicine.Despite their reliability,traditional laboratories often lag in terms of rapid diagnosis.Point-of-care testing(POCT)has emerged as a promising alternative,which is awaiting rigorous validation.We assessed 226 samples from patients at the First Affiliated Hospital of Guangzhou Medical University using a Beckman Coulter AU5821 and a PUSHKANG POCT Biochemistry Analyzer MS100.Furthermore,350 samples were evaluated with a Stago coagulation analyzer STAR MAX and a PUSHKANG POCT Coagulation Analyzer MC100.Metrics included thirteen biochemical indexes,such as albumin,and five coagulation indices,such as prothrombin time.Comparisons were drawn against the PUSHKANG POCT analyzer.Bland-Altman plots(MS100:0.8206-0.9995;MC100:0.8318-0.9911)evinced significant consistency between methodologies.Spearman correlation pinpointed a potent linear association between conventional devices and the PUSHKANG POCT analyzer,further underscored by a robust correlation coefficient(MS100:0.713-0.949;MC100:0.593-0.950).The PUSHKANG POCT was validated as a dependable tool for serum and whole blood biochemical and coagulation diagnostics.This emphasizes its prospective clinical efficacy,offering clinicians a swift diagnostic tool and heralding a new era of enhanced patient care outcomes.
文摘Purpose: To compare the effects and side-effects of fondaparinux sodium and low molecular weight heparin in patients with hypercoagulability accompanied with traumatic infection. Methods: Thirty-six patients with post-traumatic infections in our hospital intensive care center were diagnosed with hypercoagulability from February 2012 to February 2013. These patients were randomly divided into 2 groups. In group F (18 patients), the patients were treated with fondaparinux sodium, 2.5 rag, 1/d for 11 d. In group L (18 patients), the patients were treated with low molecular weight heparin, 4100 U, 1/12 h for 11 d. The incidence of deep vein thrombosis, bleeding events and multiple organ dysfunction syndrome (MODS) and mortality of two groups after anticoagulation therapy were analyzed. Fibrinogen, D-dimer level and activity of antithrombin Ⅲ were measured by the coagulation analyzer. Results: The incidence of deep vein thrombosis, MODS incidence and mortality were not significantly different between the two groups. The rate of bleeding evens in group F was lower than group L (p 〈 0.05). Antithrombin Ⅲ got an upward trend after anticoagulant therapy, in which it was higher in group F than in group L on the 5th d and llth d (p 〈 0.05). Fibrinogen levels were gradually increased, and there was no significant difference between two groups (p 〉 0.05). D-dimer was significantly decreased after anticoagulant therapy for 5 d (p 〈 0.01 ), and there were significant differences between two groups on the 5th d and 7th d (p 〈 0.05). It showed no significant difference on the llth d (p 〉 0.05). Conclusion: Fondaparinux sodium and low molecular weight heparin can effectively improve coagulopathy in patients with traumatic infection. Compared with low molecular weight heparin, fondaparinux sodium may reduce the risk of bleeding events in patients with hypercoagulability accompanied by traumatic infection.
文摘Objective To investigate the pathogenesis of thromboembolism in patients with mitral stenosis in a pre-thrombotic state.Methods The biochemical markers’ levels in plasma for platelet activity [soluble P-selectin (GMP-140)],states of thrombin generation [antithrombin Ⅲ (AT Ⅲ) and protein C (PC)],fibrinolysis [D-dimer (DD), plasminogen activator inhibitor 1 (PAI-1),tissue plasminogen activator (t-PA) and FDP] and von Willebrand factor (vWF) were determined from blood specimens obtained from the femoral veins and arteries and the right and left atria of 43 consecutive patients (20 with atrial fibrillation and 23 with sinus rhythm) with mitral stenosis (MS),undergoing percutaneous mitral valvuloplasty. The same parameters were compared with those of 15 control subjects,who had no detectable heart disease,but with paroxysmal supraventricular tachycardia undergoing radiofrequency catheter ablation of the left accessory pathway through a transseptal passage. Results Blood from the left atrium contained an excessive amount of platelet activity,thrombin generation and fibrinolysis compared with the blood from the right atrium,and the femoral veins and arteries. However blood from the right atrium was much lower in these activities when compared with those from the left atrium,and the femoral veins and arteries in both groups. Compared with those in the control subjects, GMP-140 in the left atrium was significantly higher ( P <0.05) and AT Ⅲ was significantly lower ( P <0.05) in patients with MS. Compared with the patients with MS and spontaneous left atrial echocontrast (LASEC)≤1,the patients with MS and LASEC≥2 had significantly higher levels of GMP-140 in plasma ( P <0.05),and significantly lower levels of AT Ⅲ ( P <0.05) and PC ( P <0.01) levels in the left atrium. However, there were no significant differences between patients with atrial fibrillation and those with sinus rhythm regarding amounts of plasma coagulation markers in the left atrium. Univariate regression analysis revealed that LASEC was negatively correlated with plasma levels of blood from the left atria in the patients with MS. Conclusion Coagulability is increased in the left atria of patients with MS and is positively correlated with LASEC.
基金supported by the National Natural Science Foundation of China (No.U1810205).
文摘The coagulation process is a widely applied technology in water and wastewater treatment.Novel composite polyferric mag-nesium-silicate-sulfate(PFMS)coagulants were synthesized using Na_(2)SiO_(3)·9H_(2)O,Fe_(2)(SO_(4))_(3),and MgSO_(4) as raw materials in this paper.The effects of aging time,Fe:Si:Mg,and OH:M molar ratios(M represents the metal ions)on the coagulation performance of the as-pre-pared PFMS were systematically investigated to obtain optimum coagulants.The results showed that PFMS coagulant exhibited good co-agulation properties in the treatment of simulated humic acid-kaolin surface water and reactive dye wastewater.When the molar ratio was controlled at Fe:Si:Mg=2:2:1 and OH:M=0.32,the obtained PFMS presented excellent stability and a high coagulation efficiency.The removal efficiency of ultraviolet UV254 was 99.81%,and the residual turbidity of the surface water reached 0.56 NTU at a dosage of 30 mg·L^(-1).After standing the coagulant for 120 d in the laboratory,the removal efficiency of UV254 and residual turbidity of the surface wa-ter were 88.12%and 0.68 NTU,respectively,which accord with the surface water treatment requirements.In addition,the coagulation performance in the treatment of reactive dye wastewater was greatly improved by combining the advantages of magnesium and iron salts.Compared with polyferric silicate-sulfate(PFS)and polymagnesium silicate-sulfate(PMS),the PFMS coagulant played a better decolor-ization role within the pH range of 7-13.
基金supported by grants from National Key R&D Program of China(No.2023YFC2507800)ECCM Program of Clinical Research Centre of Shandong University(No.2021SDUCRCB008)+2 种基金Young Taishan Scholar Foundation of Shandong Province(No.tsqn201812133)the Fundamental Research Funds of Shandong University(No.2020QNQT001)National Natural Science Foundation of China(No.81900124).
文摘Objective Coagulation abnormalities are common and prognostically significant in intensive care units(ICUs)and are associated with increased mortality.This study aimed to explore the association between the levels of coagulation markers and the risk of mortality among ICU patients with coagulation abnormalities.Methods This retrospective study investigated patients with coagulation abnormalities in the ICU between January 2021 and December 2022.The initial point for detecting hemostatic biomarkers due to clinical assessment of coagulation abnormalities was designated day 0.Patients were followed up for 28 days,and multivariate logistic regression analysis was utilized to identify risk factors for mortality.Results Of the 451 patients analyzed,115 died,and 336 were alive at the end of the 28-day period.Multivariate analysis revealed that elevated thrombin-antithrombin complex(TAT),tissue plasminogen activator inhibitor complex(tPAIC),prolonged prothrombin time,and thrombocytopenia were independent risk factors for mortality.For nonovert disseminated intravascular coagulation(DIC)patients,older age and thrombocytopenia were associated with increased risks of mortality,whereas elevated levels of plasminα2-plasmin inhibitor complex(PIC)were found to be independent predictors of survival.In patients with overt DIC,elevated levels of tPAIC were independently associated with increased risks of mortality.Nevertheless,thrombocytopenia was independently associated with increased risks of mortality in patients with pre-DIC.Conclusion Coagulation markers such as the TAT,tPAIC,PIC,and platelet count were significantly associated with mortality,underscoring the importance of maintaining a balance between coagulation and fibrinolysis.These findings highlight the potential for targeted therapeutic interventions based on specific coagulation markers to improve patient outcomes.
基金supported by the National Key Research and Development Program of China(2021YFC2501800)Shanghai Committee of Science and Technology(20Y11900100,21MC1930400,and 20DZ2261200)Clinical Research Plan of Shanghai Hospital Development Center(SHDC2020CR4059)。
文摘BACKGROUND:Disseminated intravascular coagulation(DIC)is associated with increased mortality in sepsis patients.In this study,we aimed to assess the clinical ability of sepsis-induced coagulopathy(SIC)and sepsis-associated coagulopathy(SAC)criteria in identifying overt-DIC and preDIC status in sepsis patients.METHODS:Data from 419 sepsis patients were retrospectively collected from July 2018 to December 2022.The performances of the SIC and SAC were assessed to identify overt-DIC on days 1,3,7,or 14.The SIC status or SIC score on day 1,the SAC status or SAC score on day 1,and the sum of the SIC or SAC scores on days 1 and 3 were compared in terms of their ability to identify pre-DIC.The SIC or SAC status on day 1 was evaluated as a pre-DIC indicator for anticoagulant initiation.RESULTS:On day 1,the incidences of coagulopathy according to overt-DIC,SIC and SAC criteria were 11.7%,22.0%and 31.5%,respectively.The specificity of SIC for identifying overt-DIC was significantly higher than that of the SAC criteria from day 1 to day 14(P<0.05).On day 1,the SIC score with a cut-off value>3 had a significantly higher sensitivity(72.00%)and area under the curve(AUC)(0.69)in identifying pre-DIC than did the SIC or SAC status(sensitivity:SIC status 44.00%,SAC status 52.00%;AUC:SIC status 0.62,SAC status 0.61).The sum of the SIC scores on days 1 and 3 had a higher AUC value for identifying the pre-DIC state than that of SAC(0.79 vs.0.69,P<0.001).Favorable effects of anticoagulant therapy were observed in SIC(adjusted hazard ratio[HR]=0.216,95%confidence interval[95%CI]:0.060–0.783,P=0.018)and SAC(adjusted HR=0.146,95%CI:0.041–0.513,P=0.003).CONCLUSION:The SIC and SAC seem to be valuable for predicting overt-DIC.The sum of SIC scores on days 1 and 3 has the potential to help identify pre-DIC.