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Role of microparticles in endothelial dysfunction and arterial hypertension

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World Journal of Cardiology 2014年第11期6卷 1135-1139页

作者： Thomas Helbing Christoph Olivier Christoph Bode Martin Moser Philipp Diehl Department of Cardiology and Angiology I Heart Center Freiburg University79106 Freiburg Germany

Microparticles are small cell vesicles that can be released by almost all eukaryotic cells during cellular stress and cell activation. Within the last 1-2 decades it has been shown that microparticles are useful blood surrogate markers for different pathological conditions, such as vascular inflammation, coagulation and tumour diseases. Several studies have investigated the abundance of microparticles of different cellular origins in multiple cardiovascular diseases. It thereby has been shown that microparticles released by platelets, leukocytes and endothelial cells can be found in conditions of endothelial dysfunction, acute and chronic vascular inflammation and hypercoagulation. In addition to their function as surrogate markers, several studies indicate that circulating microparticles can fuse with distinct target cells, such as endothelial cells or leukocyte, and thereby deliver cellular components of their parental cells to the target cells. Hence, microparticles are a novel entity of circulating, paracrine, biological vectors which can influence the phenotype, the function and presumably even the transcriptome of their target *** review article aims to give a brief overview about the microparticle biology with a focus on endothelial activation and arterial hypertension. More detailed information about the role of microparticles in pathophysiology and disease can be found in already published work.

关键词： coagulation microparticle thereby circulating eukaryotic inflammation vesicles parental phenotype cardiovascular

The clinical application of non-biotype artificial liver support system to acute liver failure of children

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China Medical Abstracts(Internal Medicine) 2014年第1期31卷 44-44页

作者：葛许华 Dept Emerg Nanjing Children's Hosp

Objective To explore the therapeutic effect of non-biotype artificial liver support system(NBALSS)in acute liver failure(ALF)of children by analyzing the data of16 children with ALF treated with plasma exchange(PE)and... 详细信息

关键词： children PICU admitted fetoprotein admission prothrombin routine bilirubin coagulation vasoactive

Reducing transfusion requirements in liver transplantation

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World Journal of Transplantation 2015年第4期5卷 165-182页

作者： Ciara I Donohue Susan V Mallett Royal Free Perioperative Research Group (RoFPoR) Department of AnaesthesiaRoyal Free London NHS Trust

Liver transplantation(LT) was historically associated with massive blood loss and transfusion. Over the past two decades transfusion requirements have reduced dramatically and increasingly transfusionfree transplantation is a reality. Both bleeding and transfusion are associated with adverse outcomes in LT. Minimising bleeding and reducing unnecessary transfusions are therefore key goals in the perioperative period. As the understanding of the causes of bleeding has evolved so too have techniques to minimize or reduce the impact of blood loss. Surgical "piggyback" techniques, anaesthetic low central venous pressure and haemodilution strategies and the use of autologous cell salvage, point of care monitoring and targeted correction of coagulopathy, particularly through use of factor concentrates, have all contributed to declining reliance on allogenic blood products. Pre-emptive management of preoperative anaemia and adoption of more restrictive transfusion thresholds is increasingly common as patient blood management(PBM) gains momentum. Despite progress, increasing use of marginal grafts and transplantation of sicker recipients will continue to present new challenges in bleeding and transfusion management. Variation in practice across different centres and within the literature demonstrates the current lack of clear transfusion guidance. In this article we summarise the causes and predictors of bleeding and present the evidence for a variety of PBM strategies in LT.

关键词： Liver transplantation Transfusion Blood conservation Patient blood management coagulation

Respiratory System Pleura

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China Medical Abstracts(Internal Medicine) 2009年第3期26卷 153-153页

ACD-A solution as anticoagulant during continuous renal replacement therapy in high risk bleeding patients

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China Medical Abstracts(Internal Medicine) 2014年第3期31卷 185-185页

作者：杨松涛 Dept Nephrol Aerospace Centr Hosp

Objective To assess the efficacy and safety of ACDA solution as anticoagulant during continuous renal replacement therapy(CRRT)in high risk of bleeding *** Forty high risk bleeding patients on continuous veno-venous hemofiltration(CVVH)were randomly divided into two groups:ACD-A group(22 patients,61 cases)and heparin-free group(18 patients,47cases).Serum creatinine,function of the

关键词： bleeding hemofiltration replacement heparin creatinine coagulation CRRT CVVH Serum monitored

Anticoagulant modulation of inflammation in severe sepsis

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World Journal of Critical Care Medicine 2015年第2期4卷 105-115页

作者： Karen S Allen Eva Sawheny Gary T Kinasewitz Section of Pulmonary and Critical Care University of Oklahoma Health Sciences Center

Inflammation and coagulation are so tightly linked that the cytokine storm which accompanies the development of sepsis initiates thrombin activation and the development of an intravascular coagulopathy. This review examines the interaction between the inflammatory and coagulation cascades, as well as the role of endogenous anticoagulants in regulating this interaction and dampening the activity of both pathways. Clinical trials attempting to improve outcomes in patients with severe sepsis by inhibiting thrombin generation with heparin and or endogenous anticoagulants are reviewed. In general, these trials have failed to demonstrate that anticoagulant therapy is associated with improvement in mortality or morbidity. While it is possible that selective patients who are severelyill with a high expected mortality may be shown to benefit from such therapy, at the present time none of these anticoagulants are neither approved nor can they be recommended for the treatment of sepsis.

关键词： Inflammation Protein C Heparin Tissue factor pathway inhibitor Thrombomodulin Antithrombin Sepsis coagulation Neutrophil extracellular traps

Thromboelastographic reference ranges for a cirrhotic patient population undergoing liver transplantation

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World Journal of Transplantation 2016年第3期6卷 583-593页

作者： Lesley De Pietri Marcello Bianchini Gianluca Rompianesi Elisabetta Bertellini Bruno Begliomini Division of Anaesthesiology and Intensive Care Unit Department of Cardiology Thoracic and Vascular Surgery Critical Care Medicine Arcispedale Santa Maria Nuova Gastroenterology Unit Department of Internal Medicine Azienda Ospedaliero Universitaria di Modena Liver and Multivisceral Transplant Center Azienda Ospedaliero-Universitaria di Modena Division of Anaesthesiology and Intensive Care Unit Department of Surgery Azienda Ospedaliero Universitaria di Modena

AIM To describe the thromboelastography(TEG) "reference" values within a population of liver transplant(LT) candidates that underline the differences from healthy *** Between 2000 and 2013, 261 liver transplant patients with a model for end-stage liver disease(MELD) score between 15 and 40 were studied. In particular the adult patients(aged 18-70 years) underwent to a first LT with a MELD score between 15 and 40 were included, while all patients with acute liver failure, congenital bleeding disorders, and anticoagulant and/or antiplatelet drug use were excluded. In this population of cirrhotic patients, preoperative haematological and coagulation laboratory tests were collected, and the pretransplant thromboelastographic parameters were studied and compared with the parameters measured in a previously studied population of 40 healthy subjects. The basal TEG parameters analysed in the cirrhotic population of liver candidates were as follows: Reaction time(r), coagulation time(k), Angle-Rate of polymerization of clot(α Angle), Maximum strenght of clot(MA), Amplitudes of the TEG tracing at 30 min and 60 min after MA is measured(A30 and A60), and Fibrinolysis at 30 and 60 min after MA(Ly30 and Ly60). The possible correlation between the distribution of the reference range and the gender, age, MELD score(higher or lower than 20) and indications for transplantation(liver pathology) were also investigated. In particular, a MELD cut-off value of 20 was chosen to verify the possible correlation between the thromboelastographic reference range and MELD score. RESULTS Most of the TEG reference values from patients with end-stage liver disease were significantly different from those measured in the healthy population and were outside the suggested normal ranges in up to 79.3% of subjects. Wide differences were found among all TEG variables, including r(41.5% of the values), k(48.6%), α(43.7%), MA(79.3%), A30(74.4%) and A60(80.9%), indicating a prevailing trend to h

关键词： Thromboelastography Liver cirrhosis Blood coagulation disorder Liver transplantation Reference values

Chronic radiation proctopathy: A practical review of endoscopic treatment

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World Journal of Gastrointestinal Surgery 2016年第2期8卷 151-160页

作者： Luciano Lenz Rachel Rohr Frank Nakao Ermelindo Libera Angelo Ferrari Fleury Medicina e Saue Centro de Medicina Diagnatica SaPaulo 04513-100 Brazil Endoscopy Unity Universidade Federal de SaPaulo SaPaulo 04513-100 Brazil Endoscopy Unit Hospital Israelita Albert EinsteinSao Paulo 04513-100 Brazil

Chronic radiation proctopathy(CRP) is a troublesome complication of pelvic radiotherapy. The most common presentation is rectal bleeding. CRP symptoms interfere with daily activities and decrease quality of life. Rectal bleeding management in patients with CRP represents a conundrum for practitioners. Medical therapy is ineffective in general and surgical approach has a high morbidmortality. Endoscopy has a role in the diagnosis,staging and treatment of this disease. Currently available endoscopic modalities are formalin,potassium titanyl phosphate laser,neodymium:yttrium-aluminum-garnet laser,argon laser,bipolar electrocoagulation(BiCAP),heater probe,band ligation,cryotherapy,radiofrequency ablation and argon plasma coagulation(APC). Among these options,APC is the most promising.

关键词： Endoscopic treatment Radiation proctopathy Proctitis Argon plasma coagulation Cryotherapy Radiofrequency ablation Formalin Laser Bipolar probe Pelvic radiotherapy

Detection of active bleeding from gastric antral vascular ectasia by capsule endoscopy

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World Journal of Gastrointestinal Endoscopy 2013年第3期5卷 138-140页

作者： Tetsuya Ohira Akira Hokama Nagisa Kinjo Manabu Nakamoto Chiharu Kobashigawa Yuya Kise Satoshi Yamashiro Fukunori Kinjo Yukio Kuniyoshi Jiro Fujita Department of Endoscopy University Hospital of the RyukyusOkinawa 903-0125Japan Department of Infectious Respiratory and Digestive MedicineGraduate School of MedicineUniversity of the RyukyusOkinawa 903-0125Japan Division of Thoracic and Cardiovascular Surgery Graduate School of MedicineUniversity of the RyukyusOkinawa 903-0125Japan

Gastric antral vascular ectasia(GAVE) has been recognized as one of the important causes of occult and obscure gastrointestinal *** diagnosis is typically made based on the characteristic endoscopic features,including longitudinal row of flat,reddish stripes radiating from the pylorus into the antrum that resemble the stripes on a *** appearances,however,can easily be misinterpreted as moderate to severe *** it is believed that capsule endoscopy(CE) is not helpful for the study of the stomach with its large lumen,GAVE can be more likely to be detected at CE rather than conventional *** can be regarded as "physiologic" endoscopy,without the need for gastric inflation and subsequent compression of the *** blood flow of the ecstatic vessels may be diminished in an inflated ***,GAVE may be prominent in *** herein describe a case of active bleeding from GAVE detected by CE and would like to emphasize a possibility that CE can improve diagnostic yields for GAVE.

关键词： Gastrointestinal bleeding Gastrointestinal endoscopy Capsule endoscopy Gastric antral vascular ectasia Argon plasma coagulation