The chemical modification of human plasminogen(HPg) was studied with 1-ethyl-3-(3- dimethyl aminopropyl) carbodiimide(EDC), N -acetylimidazole(NAI), 1,2-cyclohexanedione(CHD), chloramine T(Ch-T) and N -bro...The chemical modification of human plasminogen(HPg) was studied with 1-ethyl-3-(3- dimethyl aminopropyl) carbodiimide(EDC), N -acetylimidazole(NAI), 1,2-cyclohexanedione(CHD), chloramine T(Ch-T) and N -bromosuccinimide(NBS) as modifying reagents at its carboxyl group, tyrosine, arginine, methionine and tryptophan residues, respectively. The results indicate that tyrosine and arginine residues are not essential for HPg activity, while carboxyl groups, methionine and tryptophan residues are important for the activity of HPg. The Keech and Farrant′s kinetic analysis reveals that one tryptophan residue, one methionine residue and two carboxyl groups are essential for HPg activity.展开更多
BACKGROUND Valvular heart disease affects more than 100 million people worldwide and is associated with significant morbidity and mortality.The prevalence of at least moderate valvular heart disease is 2.5%across all ...BACKGROUND Valvular heart disease affects more than 100 million people worldwide and is associated with significant morbidity and mortality.The prevalence of at least moderate valvular heart disease is 2.5%across all age groups,but its prevalence increases with age.Mitral regurgitation and aortic stenosis are the most frequent types of valvular heart disease in the community and hospital context,res-pectively.Surgical valve replacement(or mitral valve repair)is the standard of care for treating heart valve disease.However,the replacement of a prosthetic heart valve can lead to complications,either in the peri-procedural phase or in the long-term follow-up period.CASE SUMMARY We present a case of a 71-year-old female patient with a history of mitral valve replacement and warfarin anti-coagulation therapy.She was admitted to the intensive care unit due to spontaneously reperfused ischemic stroke of probable cardioembolic etiology.A dysfunctional mitral prosthesis was identified due to malfunction of one of the fixed discs.Furthermore,a possible microthrombotic lesion was suspected.Therefore,systemic thrombolysis was performed with subsequent normalization of mitral disc opening and closing.CONCLUSION This case underscores the critical importance of a multidisciplinary approach for timely decision-making in critically ill patients with prosthetic valve complications.展开更多
目的探讨急性脑梗死(acute cerebral infarction,ACI)采用依达拉奉右莰醇(edaravone and dexcamphenol,ED)、重组人组织型纤溶酶原激活物(recombinant human tissue plasminogen activator,rt-PA)静脉溶栓治疗的临床效果。方法选取2021...目的探讨急性脑梗死(acute cerebral infarction,ACI)采用依达拉奉右莰醇(edaravone and dexcamphenol,ED)、重组人组织型纤溶酶原激活物(recombinant human tissue plasminogen activator,rt-PA)静脉溶栓治疗的临床效果。方法选取2021年12月至2023年11月赣州市南康区第一人民医院收治的82例ACI患者作为研究对象,按照随机数字表法分为对照组与联合组,每组41例。对照组采取rt-PA静脉溶栓治疗,联合组在此基础上联合ED治疗。比较两组临床疗效、神经保护因子指标[脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)、胶质纤维酸性蛋白(glial fibrillary acidic protein,GFAP)、胰岛素样生长因子1(insulin-like growth factor 1,IGF-1)]、美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分、不良反应及短期预后。结果联合组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,两组血清BDNF、IGF-1水平均高于治疗前,GFAP水平低于治疗前,且联合组血清BDNF、IGF-1水平均高于对照组,GFAP水平低于对照组,差异有统计学意义(P<0.05)。治疗1、7 d后,联合组NIHSS评分均低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。随访60 d后,联合组脑梗死溶栓治疗血流灌注分级≥2b级率高于对照组,血管急性再闭塞率低于对照组,差异有统计学意义(P<0.05);两组病死率比较差异无统计学意义。结论ED联合rt-PA静脉溶栓治疗ACI患者的疗效显著,能减轻患者神经功能缺损程度,提高闭塞血管再通率,且安全性良好。展开更多
基金Supported by the Natural Science Foundation of Jilin Province( No.0 30 912 )
文摘The chemical modification of human plasminogen(HPg) was studied with 1-ethyl-3-(3- dimethyl aminopropyl) carbodiimide(EDC), N -acetylimidazole(NAI), 1,2-cyclohexanedione(CHD), chloramine T(Ch-T) and N -bromosuccinimide(NBS) as modifying reagents at its carboxyl group, tyrosine, arginine, methionine and tryptophan residues, respectively. The results indicate that tyrosine and arginine residues are not essential for HPg activity, while carboxyl groups, methionine and tryptophan residues are important for the activity of HPg. The Keech and Farrant′s kinetic analysis reveals that one tryptophan residue, one methionine residue and two carboxyl groups are essential for HPg activity.
文摘BACKGROUND Valvular heart disease affects more than 100 million people worldwide and is associated with significant morbidity and mortality.The prevalence of at least moderate valvular heart disease is 2.5%across all age groups,but its prevalence increases with age.Mitral regurgitation and aortic stenosis are the most frequent types of valvular heart disease in the community and hospital context,res-pectively.Surgical valve replacement(or mitral valve repair)is the standard of care for treating heart valve disease.However,the replacement of a prosthetic heart valve can lead to complications,either in the peri-procedural phase or in the long-term follow-up period.CASE SUMMARY We present a case of a 71-year-old female patient with a history of mitral valve replacement and warfarin anti-coagulation therapy.She was admitted to the intensive care unit due to spontaneously reperfused ischemic stroke of probable cardioembolic etiology.A dysfunctional mitral prosthesis was identified due to malfunction of one of the fixed discs.Furthermore,a possible microthrombotic lesion was suspected.Therefore,systemic thrombolysis was performed with subsequent normalization of mitral disc opening and closing.CONCLUSION This case underscores the critical importance of a multidisciplinary approach for timely decision-making in critically ill patients with prosthetic valve complications.
文摘目的探讨急性脑梗死(acute cerebral infarction,ACI)采用依达拉奉右莰醇(edaravone and dexcamphenol,ED)、重组人组织型纤溶酶原激活物(recombinant human tissue plasminogen activator,rt-PA)静脉溶栓治疗的临床效果。方法选取2021年12月至2023年11月赣州市南康区第一人民医院收治的82例ACI患者作为研究对象,按照随机数字表法分为对照组与联合组,每组41例。对照组采取rt-PA静脉溶栓治疗,联合组在此基础上联合ED治疗。比较两组临床疗效、神经保护因子指标[脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)、胶质纤维酸性蛋白(glial fibrillary acidic protein,GFAP)、胰岛素样生长因子1(insulin-like growth factor 1,IGF-1)]、美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分、不良反应及短期预后。结果联合组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,两组血清BDNF、IGF-1水平均高于治疗前,GFAP水平低于治疗前,且联合组血清BDNF、IGF-1水平均高于对照组,GFAP水平低于对照组,差异有统计学意义(P<0.05)。治疗1、7 d后,联合组NIHSS评分均低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。随访60 d后,联合组脑梗死溶栓治疗血流灌注分级≥2b级率高于对照组,血管急性再闭塞率低于对照组,差异有统计学意义(P<0.05);两组病死率比较差异无统计学意义。结论ED联合rt-PA静脉溶栓治疗ACI患者的疗效显著,能减轻患者神经功能缺损程度,提高闭塞血管再通率,且安全性良好。
文摘目的:探讨替罗非班联合注射用重组人TNK组织型纤溶酶原激活剂(rhTNK-tPA)治疗发病6 h内急性ST段抬高型心肌梗死(STEMI)患者的临床效果。方法:回顾性选取2021年10月~2024年8月期间某院收治的120例行急诊经皮冠状动脉介入术(PCI)的急性STEMI患者的临床资料,依据患者PCI中冠状动脉内用药方案不同分为对照组(n=58,冠状动脉内注射rhTNK-tPA)和观察组(n=62,冠状动脉内注射替罗非班联合rhTNK-tPA)。分析比较两组患者心肌梗死溶栓治疗临床试验(TIMI)血流分级情况、炎症介质[白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、心功能指标[左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)]及治疗后30天内主要心血管不良事件的发生情况。结果:观察组患者给药后8 min TIMI血流3级占比(88.71%)高于对照组(74.14%,P<0.05)。治疗后,两组患者IL-6、TNF-α、LVEDD和LVESD均降低,且观察组低于对照组(P<0.05);LVEF均升高,且观察组高于对照组(P<0.05)。两组患者心血管不良事件总发生率比较无统计学差异(P>0.05)。结论:冠状动脉内应用替罗非班联合rhTNK-tPA可显著提高发病6 h内急性STEMI患者术后再灌注效果,改善心功能指标和炎症介质水平,且不额外增加术后心血管不良事件的发生风险。
