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Myocardial infarction following recombinant tissue plasminogen activator treatment for acute ischemic stroke： a dangerous complication

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Chinese Medical Journal 2012年第15期125卷 2775-2776页

作者： ZHOU Zhi-gang WANG Rui-lan YU Kang-long Department of Emergency and Intensive Care Medicine ShanghaiFirst People's Hospital Shanghai Jiao Tong University Shanghai201620 China

Thrombolysis with intravenous tissue plasminogen activator （t-PA） is currently an approved therapy for patients with acute ischemic stroke. Acute myocardial infarction （AMI） immediately following t-PA treatment for stroke is a rare but serious complication. A case of acute myocardial infarction （MI） following IV t-PA infusion for acute stroke was observed. This is a 52-year-old male with a known history of hypertension and chest pain, who subsequently developed MI four hours after IV t-PA was administered for acute ischemic stroke. The disruption of intra-cardiac thrombus and subsequent embolization to the coronary arteries may be an important mechanism. In addition, spontaneous recanalization of infarct-related arteries may be associated with greater myocardial salvage and better prognosis.

关键词： stroke myocardial infarction tissue plasminogen activator

Roles of tissue plasminogen activator in epidermal stratification

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Roles of tissue plasminogen activator in epidermal stratific...

Prevention of peritoneal adhesions:A promising role for gene therapy

中国细胞生物学学会第八届会员代表大会暨学术大会

作者：连小华杨恬 Department of Cell Biology Third Military Medical University Chongqing 400038 Dept.of Cell Biology Third Military Medical Univ

Epidermal stratification has a primary role in the epidermal barrier formation and in wound reepithelialization, and abnormal keratinocyte stratification is a consistent feature of several cutaneous disorders. In the process of keratinocyte stratification, proteolysis plays a crucial role. The tissue plasminogen activator (tPA) expressed predominantly both in the lesional epidermis and in the epidermis during wound repair, and is localized focally in the suprabasal keratinocytes, so it suggests that tPA may be related to epidermal keratinocyte stratification, but roles of tPA in regulating epidermal stratification remain unknown. In present study, using synthetic tPA and monoclonal tPA antibody, we examined the importance and mechanism of tPA in modulating of keratinocyte stratification. Histological investigation of the stratified fetal skin revealed that after continually maintained at the interface of air-liquid for 7d, the addition of tPA resulted in a significant increase in epidermal stratification, more suprabasal layers with flattened and organized orderly keratinocytes were formed, and the stratum corneum was anucleated. The immunocytochemical localization of KIO by confocal laser scanning revealed that after 7d in high Ca 2+ medium , the addition of tPA severely enhanced high Ca2+-induced stratification, the epidermis piece of the keratinocyte stratification became thicker and wider, most of stratified keratinocytes expressed KIO intensely. The infrastructure of desmosomes in cultured keratinocytes was examined by electron microscopy. When cultures were incubated with high Ca2+ plus tPA antibodies, the structure of desmosomes became loosened and tended to be disassembled, however, some neighboring keratinocytes else showed no *** results indicated that in cultures in high Ca2+ medium, intense staining for E-cadherin antigen was detected in most keratinocytes and appeared concentrating on the cell surfaces. After incubation with tP

关键词： tissue plasminogen activator epidermal stratification epidermal differentiation

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World Journal of Gastroenterology 2011年第46期17卷 5049-5058页

作者： Hussein M Atta Department of Surgery Faculty of MedicineMinia University

Adhesions are the most frequent complication of abdominopelvic surgery,yet the extent of the problem,and its serious consequences,has not been adequately *** evolved as a life-saving mecha-nism to limit the spread of intraperitoneal inflammatory *** different pathophysiological mechanisms can independently trigger adhesion *** cell injury and loss during operations,tissue hypoxia and inflammation each promotes adhesion formation separately,and potentiate the effect of each *** have repeatedly demonstrated that interruption of a single pathway does not completely prevent adhesion *** review summarizes the pathogenesis of adhesion formation and the results of single gene therapy *** explores the prom-ising role of combinatorial gene therapy and vector modif ications for the prevention of adhesion formation in order to stimulate new ideas and encourage rapid advancements in this field.

关键词： Peritoneal adhesions tissue plasminogen activator Gene therapy plasminogen activator inhibi-tor tissue inhibitor of metalloproteinase Transforminggrowth factor β

Effect of Zhutan Tongluo Tang on fibrinolytic activity following intracerebral hemorrhage in rats

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Neural Regeneration Research 2011年第21期6卷 1640-1645页

作者： Yongxi Jin Xu Li Gaowen Li Lei Guo Fang Li Guoying Liu Songfang Chen Shijue Liu Department of Rehabilitation Wenzhou Municipal Hospital of Traditional Chinese Medicine Wenzhou 325005 Zhejiang Province China Department of Physiology Wenzhou Medical College Wenzhou 325035 Zhejiang Province China Department of Pharmacology Ningbo Tian Yi Vocational and Technical College Ningbo 315100 Zhejiang Province China Department of Urology Central Hospital of Xinyang Xinyang 464000 Henan Province China The Second Affiliated Hospital of Wenzhou Medical College Wenzhou 325027 Zhejiang Province China

The neuroprotective effect of Zhutan Tongluo Tang is associated with the activities of the fibrinolytic system. Thus the present study was designed to investigate therapeutic effects of Zhutan Tongluo Tang on intracerebral hemorrhage in rats, induced by injecting collagenase into one side of the caudate nucleus. Fibrinolytic indices including tissue plasminogen activator, plasminogen activator inhibitor-1 and D-Dimer were determined. The results obtained demonstrated that Zhutan Tongluo Tang treatment could alleviate the neural and behavioral impairments of intracerebral hemorrhaging rats. Increased frequencies of placing their forelimb correctly and decreased frequencies of turning left were observed. Enzyme linked immunosorbent assay showed that Zhutan Tongluo Tang could significantly elevate the concentration of plasma tissue plasminogen activator and D-Dimer, while depress plasminogen activator inhibitor-1. Immunohistochemistry demonstrated increased levels of catalase and glutathione in whole brain rat tissue following intracerebral hemorrhage. In addition, elevated expression of Bcl-2 in various hippocampal regions was seen. These findings describe the ability of Zhutan Tongluo Tang to activate the fibrinolytic system, and suggests that antioxidant and apoptosis inhibitory mechanisms may be playing a crucial role in protecting against collagenase-induced intracerebral hemorrhage.

关键词： Zhutan Tongluo Tang intracerebral hemorrhage tissue plasminogen activator plasminogen activator inhibitor-1 D-Dimer hippocampus apoptosis neural regeneration

Primary intracoronary stenting in comparison with intravenous rt-PA thrombolysis plus rescue intracoronary intervention in patients with acute myocardial infarction

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Chinese Medical Journal 2002年第2期115卷 163-165,144页

作者：蔡煦张瑞岩张建盛沈卫峰 SHEN Weifeng 张大东上海第二医科大学附属瑞金医院心脏科上海200025 Ruijin Hospital Shanghai Second Medical University Shanghai 200025 China

OBJECTIVES: To compare primary stenting in the infarct-related coronary artery with intravenous rt-PA therapy plus rescue intracoronary stenting. METHODS: Ninety-eight patients with a first acute myocardial infarction (AMI) were randomly treated with primary intracoronary stenting (primary stenting group) or with intravenous rt-PA therapy plus rescue intracoronary stenting (thrombolysis plus stenting group). Thrombolysis in myocardial infarction (TIMI) flow grade was assessed by angiography in emergency, and cardiac function (left ventricular ejection fraction, LVEF) was calculated by echocardiography before discharge between the two groups. RESULTS: There were 47 patients (97.91%) in primary stenting group and 50 patients (100%) in thrombolysis plus stenting group had achieved TIMI grade 2 - 3 flow after the procedure. But the former had more cases (93.8%) of TIMI 3 flow than that of latter (60.0%, P = 0.0001). There was no difference between the two groups in cardiac events during hospitalization. But the patients in primary stenting group had better cardiac function (LVEF 0.62 +/- 0.14 vs. 0.50 +/- 0.12, respectively, P = 0.0001) between the two groups. CONCLUSIONS: Primary intracoronary stenting may improve myocardial reperfusion in emergency and inhibit the decline of cardiac function after AMI in comparison with intravenous rt-PA thrombolysis plus rescue intracoronary stenting.

关键词： Stents Aged Angioplasty, Transluminal, Percutaneous Coronary Combined Modality Therapy Comparative Study Creatine Kinase Female Fibrinolytic Agents Humans Infusions, Intravenous Isoenzymes Male Middle Aged Myocardial Infarction Recombinant Proteins tissue plasminogen activator Treatment Outcome

Coagulation and fibrinolytic activity in patients with acute cerebral infarction

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Chinese Medical Journal 2003年第3期116卷 156-158页

作者：李峰张贵斌赵文洲 Department of Neurology People's Hospital Wuhan University Wuhan 430060 China Department of Neurology First People's Hospital of Xiangfan Hubei Province 441000 China

Objective To measure the concentration of D-dimer (DD), tissue plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1) and plasminogen (PLG) activity in plasma and cerebrospinal fluid in patients with acute cerebral infarction and to investigate their clinical *** The concentrations of D-dimer, t-PA, and PAI-1 in plasma and cerebrospinal fluid in patients were measured by enzyme-linked immunosorbent assay (ELISA). The PLG biological activity was detected using the chromophore method. The results were compared with those of the *** The concentrations of D-dimer, t-PA and PAI-1 in cerebrospinal fluid and plasma in patients with acute cerebral infarction were much higher than those of normal subjects (P<0.01). Conversely, the level of PLG activity was significantly lower in the patients than in the controls (P<0.01).Conclusion Hypercoagulability and secondary hyperfibrinolysis exist in patients with acute cerebral infarction.

关键词： infarction D-dimer tissue plasminogen activator plasminogen activator inhibitor plasminogen coagulation fibrinolytic activity

Study on the Mechanism of the Annexin -Mediated Co-Assembly of t-PA and plasminogen

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2002年第1期22卷 21-23,76页

作者：张晓晖周华荣沈关心刘仲萍魏文宁宋善俊胡豫 Department of Hematology Xiehe Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan 430022 Institute of Immunology Tongji Medical College Huazhong University of Science and Technology Wuhan 430030

In order to further investigate the effect of annexinⅡ(Ann Ⅱ) on tissue plasminogen activator (t PA) dependent plasminogen (PLG) activation and its interactive mechanism, recombinant native Ann Ⅱ bound t PA, PLG and plasmin with high affinity was examined. The flow cytometric assay showed that the ann Ⅱexpression rate was higher in the human umbilical vein endothelial cell (HUVEC) (87 65 %) than in the HL 60 cells as controls (35.79 %). Two irrelevant proteins, bovine serum albumin (BSA) and equine IgG (EIG) had no effect on the production of plasmin. Ann Ⅱ mediated enhancement of t PA dependent PLG activation was inhibited by ε aminocaproic acid or by pretreatment of Ann Ⅱ with carboxypeptidase B with the inhibitive rate being 77.8 % and 77.0 %, respectively. It was revealed that the effect of Ann Ⅱon PLG activation was specific for t PA. Urokinase didn't bind to Ann Ⅱ, demonstrating the role of receptor related lysine residues on activation of PLG, showing that the Ann Ⅱ PLG interaction was dependent upon carboxyl terminal lysine residues. These findings suggest that annexin Ⅱ mediated co assembly of t PA and PLG may promote plasmin generation and play a key role in modulating fibrinolysis on the endothelial surface.

关键词： annexin Ⅱ plasminogen tissue plasminogen activator co receptor activation

Protocoled thrombolytic therapy for frostbite improves phalangeal salvage rates

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Burns & Trauma 2020年第1期8卷 338-346页

作者： Rosemary Elizabeth Paine Elizabeth Noel Turner Daniel Kloda Carolyne Falank Bruce Chung Damien Wilson Carter Department of Surgery Maine Medical Center22 Bramhall StPortlandMaine 04102USA Department of Radiology Maine Medical Center22 Bramhall StPortlandMaine 04102USA

Background:Frostbite is a cold injury that has the potential to cause considerable morbidity and long-term *** the complexity of these patients,diagnostic and treatment practices lack *** therapy has emerged as a promising treatment modality,demonstrating impressive digit salvage *** review our experience with thrombolytic therapy for severe upper extremity ***:Retrospective data on all frostbite patients evaluated at our institution from December 2017 to March 2018 was collected.A subgroup of patients with severe frostbite treated with intraarterial thrombolytic therapy(IATT)were ***:Of the 17 frostbite patients treated at our institution,14(82%)were male and the median age was 31(range:19–73).Substance misuse was involved in a majority of the cases(58.8%).Five(29.4%)patients with severe frostbite met inclusion criteria for IATT and the remaining patients were treated *** demonstrated a 74.5%improvement in perfusion after tissue plasminogen activator *** comparing phalanges at risk on initial angiography to phalanges undergoing amputation,the phalangeal salvage rate was 83.3%and the digit salvage rate was 80%.Complications associated with IATT included groin hematoma,pseudoaneurysm and retroperitoneal ***:Thrombolytic therapy has the potential to greatly improve limb salvage and functional recovery after severe frostbite when treated at an institution that can offer comprehensive,protocoled thrombolytic therapy.A multi-center prospective study is warranted to elucidate the optimal treatment strategy in severe frostbite.

关键词： Frostbite tissue plasminogen activator Amputation Digit salvage Thrombolysis

Management of subretinal hemorrhage

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Eye Science 2017年第1期32卷 22-24页

作者： Gregg T.Kokame Department of Surgery University of Hawaii John A Burns School of MedicineHonoluluHI 96813USA Hawaii Macula and Retina Institute Hawan 96701USA Retina Consultants of Hawau HonoluluHI 96813USA

Subretinal hemorrhage is a vision threatening complication of exudative age related macular degeneration(AMD) and polypoidal choroidal vasculopathy(PCV). Timely removal or displacement of subretinal hemorrhage from the central macula, ideally within 7 to 10 days after onset, is critical to allowing potential recovery of vision. Surgical techniques with the use of a bubble to displace the subretinal hemorrhage can now be performed with tissue plasminogen activator to lyze the blood and with or without vitrectomy.

关键词： Subretinal hemorrhage age related macular degeneration(AMD) polypoidal choroidal vasculopathy(PCV) vitrectomy tissue plasminogen activator intraocular gas bubble