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Objective: To investigate the independent effects of irisin on insulin resistance (IR) in ovary of polycystic ovary syndrome (PCOS) and explore possible pathways. Methods: We established PCOS medel using Poretsky L's method, then PCOS rats were randomly divided into model group (M) and irisin group (I), and normal rats (N) were used as the control. Then rats in the group I were injected with recombinant irisin. Then the levels of circulating fasting blood glucose (FBG), fasting insulin (FINS), homeostasis model assessment of IR (HOMA‐IR) and PI3K/AKT and MAPK/ERK pathways in each group were observed, as well as the effects of irisin on the levels of circulating HOMA‐IR and PI3K/AKT and MAPK/ERK pathways in ovary of PCOS rats were evaluated. Results: Compared with normal group, levels of FBG, FINS, and HOMA‐IR of model group were significantly increased (p < 0.001, p < 0.001, and p < 0.001, respectively), levels of average optical density by IHC of p‐PI3K, PI3K, p‐AKT, and AKT (p = 0.015, p = 0.010, p = 0.005, and p = 0.009, respectively) and levels of mRNA concentration of PI3K and AKT (p = 0.001, and p = 0.005, respectively) were decreased, while the levels of average optical density of p‐ERK, ERK (p = 0.011, and p = 0.013, respectively) and level of mRNA concentration of ERK (p < 0.001) were increased in ovary. After irisin intervention, compared with model group, levels of FBG, FINS, and HOMA‐IR of rats in irisin group were significantly decreased (p = 0.001, p < 0.001, and p < 0.001, respectively), levels of average optical density by IHC of p‐PI3K, PI3K, p‐AKT, and AKT (p = 0.030, p = 0.024, p = 0.012, and p = 0.025, respectively) and levels of mRNA concentration of PI3K and AKT (p = 0.002, and p = 0.003, respectively) were significantly increased, while the levels of average optical density of p‐ERK, ERK (p = 0.004, and p = 0.026, respectively) and level of mRNA concentration of ERK (p = 0.001) were significantly decreased. Conclusion: Our study demonstrated that irisin could not only improve circulating insulin resistance, but may also improve ovarian IR through an increase in the activity of PI3K/AKT signaling and a decrease of MAPK/ERK signaling. [ABSTRACT FROM AUTHOR]

Objective To explore the application value of transnasal endoscopy combined with endovascular treatment in the operation of skull base tumors. Methods A retrospective analysis was conducted on the clinical data of 9 patients who underwent endoscopic transnasal resection of skull base tumors and received endovascular treatment at Tianjin Huanhu Hospital from January 2017 to July 2022. To observe the tumor resection and evaluate the postoperative efficacy of nasopharyngeal carcinoma according to the World Health Organization (WHO) solid tumor measurement standards. During the follow- up period, Glasgow Outcome Scale (GOS) was used to assess postoperative neurological function recovery, and record tumor recurrence or progression. Complications related to endovascular treatment, such as pseudoaneurysm, spontaneous cerebral hemorrhage and cerebral infarction, were also recorded. Results Among 9 patients, there were 4 patients confirmed donor artery or internal carotid artery (ICA) rupture by DSA before operation, one case underwent spring coil embolization before operation, one case had a carotid catheter sheath inserted in advance during operation, one case had successful hemostasis with spring coil embolization during operation, one case had successful hemostasis with covered stent implantation during operation, 4 cases had ICA rupture confirmed by DSA during operation, and one case had successful hemostasis with spring coil embolization after DSA confirmation of ICA rupture. The total resection rate was 8/9. During a follow - up of 32.00 (25.00, 48.50) months, all patients did not experience tumor recurrence or progression. At the last follow -up, the GOS scores were 4-5, indicating good recovery of neurological function. A patient with recurrent nasopharyngeal carcinoma who underwent immunotherapy had a recurrent pseudoaneurysm at the distal end of the ICA covered with a stent implanted in the petrous segment. Three months after the stent implantation, the patient underwent external carotid artery - radial artery - middle cerebral artery bypass surgery to successfully stop the bleeding without any postoperative complications. The remaining 8 patients did not experience complications such as spontaneous cerebral hemorrhage or pseudoaneurysm. All patients did not experience complications such as cerebral infarction. Conclusions Evdovascular treatment is helpful in evaluating the relationship between skull base tumors and surrounding blood vessels before endoscopic transnasal resection of skull base tumors. It can effectively block the donor artery, reduce the probability of intraoperative bleeding, effectively treat the rupture of large blood vessels, and reduce the occurrence of serious complications. The efficacy and safety are both high. [ABSTRACT FROM AUTHOR]

Introduction: Zhixue Zhentong capsules (ZXZTCs) are a Tibetan medicine preparation solely composed of Lamiophlomis rotata (Benth.) Kudo. L. rotata is the only species of the genus Laniophlomis (family Lamiaceae) that has medicinal constituents derived from the grass or root and rhizome. L. rotata is one of the most extensively used folk medicines by Tibetan, Mongolian, Naxi, and other ethnic groups in China and has been listed as a first-class endangered Tibetan medicine. The biological effects of the plant include hemostasis, analgesia, and the removal of blood stasis and swelling. Purpose: This study aimed to profile the overall metabolites of ZXZTCs and those entering the blood. Moreover, the contents of six metabolites were measured and the hemostatic, analgesic, and anti-inflammatory effects of ZXZTCs were explored. Methods: Ultra-performance liquid chromatography-tandem quadrupole timeof-flight high-resolution mass spectrometry (UPLC-Q-TOF-MS) was employed for qualitative analysis of the metabolites of ZXZTCs and those entering the blood. Six metabolites of ZXZTCs were quantitatively determined via high-performance liquid chromatography The hemostatic, analgesic, and anti-inflammatory effects of ZXZTCs were evaluated in various animal models. Results: A total of 36 metabolites of ZXZTCs were identified, including 13 iridoid glycosides, 9 flavonoids, 9 phenylethanol glycosides, 4 phenylpropanoids, and 1 other metabolite. Overall, 11 metabolites of ZXZTCs entered the blood of normal rats. Quantitative analysis of the six main metabolites, shanzhiside methyl ester, chlorogenic acid, 8-O-acetyl shanzhiside methyl ester, forsythin B, luteoloside, and verbascoside, was extensively performed. ZXZTCs exerted hemostatic effects by reducing platelet aggregation and thrombosis and shortening bleeding time. Additionally, ZXZTCs clearly had an analgesic effect, as observed through the prolongation of the latency of writhing, reduction in writhing, and increase in the pain threshold of experimental rats. Furthermore, significant anti-inflammatory effects of ZXZTCs were observed, including a reduction in capillary permeability, the inhibition of foot swelling, and a reduction in the proliferation of granulation tissue. Conclusion: Speculative identification of the overall metabolites of ZXZTCs and those entering the blood can provide a foundation for determining its biologically active constituents. The established method is simple and reproducible and can help improve the quality control level of ZXZTCs as a medicinal product. Evaluating the hemostatic, analgesic, and anti-inflammatory activities of ZXZTCs can help reveal its mechanism. [ABSTRACT FROM AUTHOR]

Objective The purpose of this study was to evaluate the diagnostic performance of the following hemostatic markers in hypertensive disorder of pregnancy (HDP): tissue-type plasminogen activator and inhibitor-1 complex (tPAI-C), thrombomodulin, thrombin-antithrombin complex, plasmin inhibitor-plasmin complex, D-dimer, and fibrinogen degradation products. Methods A total of 311 individuals diagnosed with HDP and 187 healthy controls (HC) of matched gestational age were admitted, including 175 subjects with gestational hypertension, 94 with mild preeclampsia, and 42 with severe preeclampsia. Results Compared with those of the HC group, the plasma concentrations of all the hemostatic markers continuously increased with the clinical severity of the hypertensive disorder, regardless of their statistical significance. In the receiver operating characteristic analysis, tPAI-C displayed the best discrimination performance. Conclusion The tPAI-C level was consistently and significantly elevated across the different HDP groups when compared with the HC group, suggesting aggravated fibrinolysis disorder increasing with the severity of the HDP. [ABSTRACT FROM AUTHOR]

To develop an alarm device for the mechanical compression device displacement (MCD), and further evaluate its effectiveness in clinical use. The alarm device is mainly composed of buzzer, indicator light, magnetic sheet. This is a prospective randomized and controlled study. Four hundred patients who met the inclusion/exclusion criteria were included and randomly assigned to two groups (MCD group vs alarm + MCD group). The primary outcome measures were the sensitivity and specificity of the alarm device to detect MCD displacement, time to hemostasis (TTH), time to ambulation (TTA), time to hospital discharge (TTHD), hospital costs (HC), complication rates, and patient satisfaction. The sensitivity and specificity of the alarm device in detecting MCD displacement were 94.44% and 88.46%, respectively. The study group achieved shorter TTH (p =.034), shorter TTA (p =.021), lower complication rates (p =.025), and better patients' satisfaction (p <.001) compared to the control group. However, no significant difference was observed in TTHD (p =.361) and HC (p =.583). The alarm device is highly sensitive in detecting MCD displacement, while achieving better clinical outcomes compared with artificial monitoring. [ABSTRACT FROM AUTHOR]

Copyright of Acta Edulis Fungi is the property of Acta Edulis Fungi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To compare the clinical efficacy and safety of oral administration of Buxue Yimu Pills (BYP, 补血益母丸), ferrous sulfate (FS), and the combination of BYP and FS on gynecological anemia, and investigate the mechanisms using network pharmacology. Methods: A randomized, controlled, multi-center clinical trial was conducted. Totally 150 patients with hemoglobin of 70–110 g/L due to gynecological conditions were recruited and randomized (using the block randomization method) into Buxue Yimu Pills group (24 g/d), oral iron group (FS Tablets, 0.9 g/d), and combined treatment group (BYP, 24 g/d plus FS Tablets, 0.9 g/d), 50 patients in each group. At the enrollment and 4-week treatment, complete blood count, serum iron indexes were evaluated. Adverse events, liver and renal functions, as well as blood coagulation were observed. Network pharmacology was conducted to identify the active ingredients and explore the potential mechanisms of BYP. Results: Ten (20%) and 7 (14%) participants discontinued the therapy due to gastrointestinal symptoms in oral iron and combination treatment groups. All 3 groups showed elevated hemoglobin. The patients in the iron group exhibited typically elevated in serum iron and ferritin and decreased in total iron-binding capacity. No change in iron indexes was observed in BYP group. The patients in the combination treatment group neither showed significant changes in serum ferritin nor total iron-binding capacity. No significant adverse reactions were observed in the BYP group. The network pharmacology identified 27 bioactive compounds and 145 targets of BYP on gynecological anemia. Biological processes and pathways including regulation of inflammation, hormone, angiogenesis and hemostasis, response to decreased oxygen levels, effects on myeloma cell, and response to metal ions were identified. Conclusion: BYP contributes to the practical improvement on gynecological anemia potentially through multi-target mechanisms and optimized iron re-distribution. (Trial registration: No. NCT03232554) [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective. This research aimed at better understanding the histopathological development of precancerous lesions of gastric cancer (PLGC) and organelle ultrastructure changes. Methods. Sprague-Dawley rats were randomly assigned to the model and control groups. Model rats drank N-methyl-N′-nitro-N-nitrosoguanidine solution, while control rats drank pure water ad libitum. At 1, 3, 5, 6, and 8 months after the start of feeding, eight rats were randomly chosen from each group, and gastric mucosa tissues were removed for histopathological analysis. H&E staining was applied to analyze the pathological histological structure of the rat gastric mucosa via a light microscope, and the ultrastructural changes were observed via a transmission electron microscope. Results. Gastric mucosal pathologies of model rats such as mucosal atrophy, intestinal metaplasia, inflammatory lesions, and even intraepithelial neoplasia deteriorated over time. The endoplasmic reticulum gap widened, the mitochondrial endothelial cristae were disrupted, the nuclear membrane thickened, and chromatin condensed with heterotypic alterations in the main and parietal cells. Additionally, endothelial cell enlargement and thickening of the microvascular intima were seen. Conclusion. Our research showed that the PLGC progression of rats is correlated with the pathological alteration axis of "normal gastric mucosa-gastric mucosa inflammatory changes-intestinal metaplasia with mild dysplasia-moderate to severe dysplasia." Ultrastructure analysis of model rats is compatible with the structural changes in the gastric mucosa with spleen deficiency and blood stasis. The pathological evolutionary axis and ultrastructural analysis are helpful for evaluating potential novel herbal therapies for PLGC. [ABSTRACT FROM AUTHOR]

Background: MynxGrip is a non-suture, balloon catheter- and extravascular sealant-based vascular closure device designed to help hemostasis after an arterial puncture. This study evaluated the efficacy and safety of MynxGrip versus manual compression for femoral artery access closure in patients undergoing diagnostic or interventional procedures., Methods: The PANDA multicenter, parallel-group, open-label, randomized controlled trial enrolled patients undergoing a diagnostic or interventional procedure through femoral artery access between April 2019 and September 2020 at six centers in China. The participants were randomized 2:1 to the MynxGrip group and the manual compression group. Time to hemostasis and incidence of severe complications were the primary efficacy and safety endpoints, respectively., Results: A total of 304 consecutive participants were included. The baseline characteristics were similarly distributed in the MynxGrip ( n  = 203) versus manual compression ( n  = 101) groups. Compared with the manual compression group, the median time to hemostasis and time to ambulation were significantly shorter (3.0 (interquartile range: 2.0, 4.0) vs 18.0 (11.0, 22.0) min, and 479.0 (275.0, 932.0) vs 1410.3 (1121.0, 1476.0) min, respectively; both p  = 0.0001) in the MynxGrip group, with similar procedural success rate, and without severe complications in either group. The incidence of device-related adverse events was 11.8% in the MynxGrip group, most possibly or definitely unrelated., Conclusions: Compared with manual compression, the MynxGrip vascular closure device significantly shortens the times to hemostasis and ambulation without severe complications after diagnostic or interventional procedures through the femoral artery access., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background. Vascular endothelial cell injury is not only the initiating factor of cardiovascular and cerebrovascular diseases but also the essence of blood stasis. Levistilide A (LA), a natural component isolated from the traditional Chinese herb, Ligusticum chuanxiong Hort, has traditional effects on improving blood circulation and removing stasis. In this study, the effects and potential mechanisms of LA in the rat model of blood stasis and the mechanism in endothelial cell injury have been explored. Materials and Methods. In this experiment, the effects of LA on the model of acute blood stasis in rats were explored. The blood samples were collected for the measurement of coagulation and hemorheological indices, and the carotid arteries were also excised from rats for hematoxylin-eosin (HE) staining and immunohistochemistry (IHC). In addition, the improvement effects of LA on the H2O2-induced human umbilical vein endothelial cell (HUVEC) injury model were evaluated. And the cell viability detection was conducted by the CCK8 assay, and the pathway-related protein expressions were detected by western blotting. Results. In vivo, compared with the model group, the treatment of LA (10 mg/kg) could reduce the FIB (fibrinogen) content (P < 0.01), increase the INR (international normalized ratio) and PT (prothrombin time) (P < 0.01), and reduce the plasma viscosity (P < 0.05) and whole blood viscosities of low, medium, and high shear rates in the blood of blood stasis model rats (P < 0.01). In vitro, the cell viability in the LA-pretreated group was higher than that of the model group (P < 0.05). The expression levels of PI3K, AKT, and eNOs in the LA-pretreated group were increased (P < 0.01) as compared to the model group. Conclusion. These findings demonstrated that LA has the ability to improve blood hypercoagulation and blood viscosity, and enhance the viability of cells. It is more likely that it exerts a protective effect on the endothelial cell through the PI3K-AKT-eNOs pathway. These results indicate LA will be a potential candidate to cure blood stasis with endothelial cell injury. [ABSTRACT FROM AUTHOR]

To explore the clinical characteristics and outcomes in Chinese patients with type I cryoglobulinemia (CG), we retrospectively analyzed the clinical data, management, and outcomes of 45 patients diagnosed with type I CG in our hospital from January 2015 to March 2019. In our study, all type I CGs were secondary to hematologic diseases, and monoclonal gammopathy of unknown significance was the most common primary disease, accounting for 48.9% (n = 22). Additionally, B cell non-Hodgkin lymphoma, Waldenström's macroglobulinemia, and multiple myeloma accounted for 24.4% (n = 11), 20.0% (n = 9), and 6.7% (n = 3), respectively. In patients with type I CG, skin damage was the most common symptom, presenting in 57.8% of the patients, followed by peripheral neuropathy (22.2%) and renal involvement (15.6%). Treatment was initiated in 29 patients (64.4%), and the most common choice was a rituximab-based regimen in 13 patients (44.8%), followed by bortezomib-based regimen in 11 patients (37.9%). Clinical symptoms were significantly improved after treatment, and the clinical remission rate was 86.2%, including 34.5% of complete clinical remission, while the laboratory response rate was 88.9%, including 33.3% of complete response and 55.6% of partial response. The expected 1-year overall survival was 97.8%. In conclusion, for patients with multisystemic involvement, such as skin damage, kidney damage, or peripheral neuropathy, the diagnosis of type I CG should be considered, and the underlying disease needs to be explored. Symptoms and primary diseases should be taken into consideration before choosing initial management. [ABSTRACT FROM AUTHOR]

Background and objective Thoracoscopic safe and effective hemostasis is an important condition for rapid rehabilitation of thoracic surgery. Placing hemostatic materials during surgery is a commonly used method in lung cancer laparoscopic surgery. Among them, resorbable oxidized cellulose is a commonly used hemostatic material. This research aims to observe the hemostatic effect of resorbable oxidized cellulose in lung cancer surgery. Methods A retrospective analysis of 42 patients with thoracoscopic lung cancer undergoing radical surgery in the Department of Thoracic Surgery, First Affiliated Hospital of Zhejiang University School of Medicine from July 1, 2018 to December 1, 2018, and intraoperative use of regenerative oxidized cellulose to stop bleeding The clinical and pathological data were selected and the perioperative indicators were selected as the outcome events for statistical analysis. Results The mean operative time was (120.5±57.3) min. The mean intraoperative blood loss was (26.8±21.6) mL. The average postoperative drainage volume was (513.6±359.5) mL. The average postoperative chest tube indwelling time was (2.6±1.2) d. Conclusion The use of absorbable regenerated oxidized cellulose in the radical operation of thoracoscopic lung cancer has a good hemostasis effect, and is suitable for hemostasis of wounds after lymph node dissection. [ABSTRACT FROM AUTHOR]

Introduction: An increased bleeding tendency has been shown in female haemophilia carriers compared to healthy females. Bleeding assessment tools (BATs) have mainly been performed in western cultures. It is unclear how they perform in populations with different healthcare, health/wellness concepts and awareness, as well as family planning practices. Aim: To (a) describe and compare the bleeding symptoms in carriers with healthy females, particularly for bleeding after surgical abortion and intrauterine device (IUD) placement which are performed frequently for family planning in China; (b) quantify scores of International Society on Thrombosis and Haemostasis Bleeding Assessment Tool (ISTH‐BAT) and Chinese‐BAT (C‐BAT) developed to include surgical abortion and IUD placement as separate categories in Chinese haemophilia carriers; (c) correlate bleeding scores (BS) with factor levels. Methods: We conducted a multicentre, cross‐sectional study on obligate haemophilia carriers and healthy controls using ISTH‐BAT and C‐BAT. Results: We enrolled 125 haemophilia carriers and 106 controls. Carriers, compared to controls, had significantly higher median BS (3 vs 1 by both ISTH‐BAT and C‐BAT) and lower factor level (63.5 vs 101.8 IU/dL). Bleeding after surgical abortion and IUD placement was significantly associated with carrier status. Bleeding scores from neither ISTH‐BAT nor C‐BAT showed significant correlation with factor levels. Conclusion: Haemophilia carriers in China experienced abnormal bleeding. Unique to the Chinese carriers is significant bleeding after surgical abortion (3rd highest incidence of bleeding symptom) and IUD placement (4th highest). However, both ISTH‐BAT and C‐BAT exhibited no correlation between BS and factor levels in this population and neither could identify carriers with low factor level (of <50 IU/dL). [ABSTRACT FROM AUTHOR]

Background and objective Da Vinci robotic system is currently widely used in thoracic surgery. The ports employment and procedures vary in different medical center in China. Usually, a small incision was used for assistant. Methods Based on clinical practice, we summarized domestic and foreign experience, combined with the characteristics of the Chinese body anatomy, employ portal technique and artificial pneumothorax, summarized a set of simplified and easier surgical method. Results Port-only artificial pneumothorax robot-assisted lobectomy has further improvement in anatomical safety, hemostatic effect and aesthetic appearance of the wound. Conclusion This study optimizes the procedure of port-only artificial pneumothorax robot-assisted lobectomy in order to serve lung cancer patients better. [ABSTRACT FROM AUTHOR]

The purpose of the study was to investigate baseline inflammatory, hemostatic indicators and new-onset deep vein thrombosis (DVT) with the risk of mortality in COVID-19 inpatients. In this single-center study, a total of 401 COVID-19 patients hospitalized in Sir Run Run Shaw Hospital, Zhejiang University School of Medicine were enrolled from December 1, 2022 to January 31, 2023. The basic information, first laboratory examination results, imaging examination, and outcome-related indicators were compared between patients in the moderate and severe subgroups. We found that baseline D-dimer and baseline absolute neutrophil count (ANC) levels were associated with new-onset DVT and death in severe hospitalized patients with COVID-19. The odds ratio (OR) of baseline D-dimer and baseline ANC with mortality was 1.18 (95% confidence interval [CI], 1.08-1.28; P  < .001) and 1.13 (95% CI, 1.06-1.21; P  < .001). Baseline ANC was associated with the risk of death in severe hospitalized COVID-19 patients, irrespective of the DVT status. In addition, a significantly higher serum neutrophil activity was observed in severe COVID-19 inpatients with DVT or those deceased during hospital stay. New-onset DVT partially mediated the association between baseline D-dimer (indirect effect: 0.011, estimated mediating proportion: 67.0%), baseline ANC (indirect effect: 0.006, estimated mediating proportion: 48.7%), and mortality in severe hospitalized patients with COVID-19. In summary, baseline D-dimer and baseline absolute neutrophil count (ANC) levels were associated with the mortality in severe hospitalized patients with COVID-19, especially DVT inpatients. New-onset DVT partially mediated the association between baseline D-dimer, baseline ANC, and mortality in severe hospitalized patients with COVID-19., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Toddalia asiatica root bark as an effective hemostatic natural medicine or Chinese materia medica was applied in China for long history, its complex drug action mechanisms and unclear substance basis have been constraining the development of this drug. Results: An intelligentized strategy by LC-ESI Q-TOF MS was presented in this study for rapid identification of hemostatic chemical constituents from this natural medicine. Chromatographic separation was performed on a C18 column (150 mm × 2.1 mm, 1.8 μm), the MS data in both negative and positive ion modes were acquired to record the high-accuracy MS and MS/MS data of all precursor ions. To reduce the false positive identifications, structural confirmation was conducted by comparison with the isolated reference standards (t and MS, MS/MS data) or matching with natural product databases. Bioassay-guided fractionation of the extract of T. asiatica root bark was also carried out. Conclusions: As a consequence, 31 natural compounds in T. asiatica root bark got putatively characterized. There were four main coumarins, isopimpinellin (Cp.23), pimpinellin (Cp.24), coumurrayin (Cp.30) and phellopterin (Cp.34) isolated and identified from T. asiatica root bark. The present study provided candidate strategy that helps to effectively identify the primary natural compounds of TCM or other complex natural medicines, and then promote development and application of natural medicines and their medicinal resources. [ABSTRACT FROM AUTHOR]

Microneedle patches have been extensively employed for wound healing, while the lack of rapid hemostasis efficiency and multiple tissue-repair properties restrict their values in hemorrhagic wound applications. Herein, we propose a Yunnan Baiyao-loaded multifunctional microneedle patch, namely (BY + EGF)@MN, with deep tissue penetration, hemostasis efficiency and regenerative properties for hemorrhagic wound healing. The (BY + EGF)@MNs are designed with a BY-loaded Bletilla striata polysaccharide (BSP) base for rapid hemostasis and epidermal growth factor (EGF)-loaded GelMA tips for subsequent wound healing. As the BSP base can be fastly dissolved and completely release BY in 6 min to promote platelet adhesion and activate coagulation system, while the EGF can achieve a controlled and sustained release behavior in 7 days with the gradual degradation of the GelMA tips, the (BY + EGF)@MNs exhibit strong pro-coagulability and satisfactory hemostatic effect in a rat hepatic hemorrhage wound model. Based on the multifunctional characteristics, we have verified that when applied in rat cutaneous wounds, the proposed MNs can accelerate the wound healing process by enhancing neovascularization, fibroblast density, and collagen deposition. Thus, we believe that such (BY + EGF)@MNs are promising candidates for rapid hemostasis and diverse wound healing applications., (© 2023. The Author(s).)

Panax japonicus C.A.Mey, the traditional medicinal herb in the Araliaceae family, has been used as a tonic, anti-inflammatory and haemostatic agent in China for more than thousand years. Its clinical effects are mainly due to the presence of triterpenoid saponins. However, little is known at the genetic level about how saponins are biosynthesized in this plant. We have therefore performed the de novo transcriptome assembly and high throughput RNA-seq analysis for P. japonicus . 66,403 unigenes were assembled from 19.6 Gbp raw data, and 34,639 unigenes were annotated. After annotation, 29 unigenes involved in putative backbone biosynthesis of triterpenoid saponin were selected. Additionally, 34 Cytochrome P450 and 18 UDP-glycosyltransferase unigenes were predicted based on the annotation, which were related to the saponin backbone modification. The expression level of related key genes were further verified by qPCR analysis. The results of this study provide the most comprehensive expressed sequence resources for P. japonicus , which will enlarge the available P. japonicus gene pool and facilitate further genome-wide research and analyses in this species. [ABSTRACT FROM AUTHOR]

This is a multicenter prospective cohort study to analyze the correlation of traditional Chinese medicine (TCM) syndrome evolvement and cardiovascular events in patients with stable coronary heart disease (CHD). The impact of syndrome evolvement on cardiovascular events during the 6-month and 12-month follow-up was analyzed using complex networks approach. Results of verification using Chi-square test showed that the occurrence of cardiovascular events was positively correlated with syndrome evolvement when it evolved from toxic syndrome to Qi deficiency, blood stasis, or sustained toxic syndrome, when it evolved from Qi deficiency to blood stasis, toxic syndrome, or sustained Qi deficiency, and when it evolved from blood stasis to Qi deficiency. Blood stasis, Qi deficiency, and toxic syndrome are important syndrome factors for stable CHD. There are positive correlations between cardiovascular events and syndrome evolution from toxic syndrome to Qi deficiency or blood stasis, from Qi deficiency to blood stasis, or toxic syndrome and from blood stasis to Qi deficiency. These results indicate that stable CHD patients with pathogenesis of toxin consuming Qi, toxin leading to blood stasis, and mutual transformation of Qi deficiency and blood stasis are prone to recurrent cardiovascular events. [ABSTRACT FROM AUTHOR]

Various herbal medicines with hemostatic properties have been applied for centuries to accelerate hemostasis and control bleeding. However, the mechanisms of action and active constituents remain unknown. This report provides an overview of current clinical hemostatic agents and their disadvantages, then focuses on the clinical value of Chinese herbal medicines with unique hemostatic features that modern medicines lack. A comprehensive review of hemostatic agents derived from Chinese herbal medicines and their potential medical applications is also presented.

Introduction: The aim of the present study was to validate prothrombin time (PT) international normalized ratio (INR) results obtained using Steelex test reagents and a Steelex coagulometer (Steelex Scientific Instrument Company, Beijing, China), in comparison with use of a well-established standard test employing Pacific Hemostasis reagents (Fisher Diagnostics, Middletown, VA, USA) and Teco Coatron A4 coagulometer (Teco Medical Instruments GmbH, Neufahrn, Germany). Materials and methods: Between- and within-day coefficients of variation (CVs) of both assays were calculated using control samples provided by the test manufacturers. Samples from 90 subjects were collected and INR values were determined in a double-blind parallel manner employing both systems. Results: The within-day coefficients of variation (CVs) in INR estimates ranged from 2.6% (INR = 1.12) to 3.1% (INR = 2.51) for the Steelex system and from 2.1% (INR = 1.09) to 1.8% (INR = 2.8) for the Pacific test; the between-day values ran from 3.4% (INR = 1.16) to 7.9% (INR =2.64) and from 3.3% (INR = 1.1) to 2.3% (INR = 2.7), respectively. Passing-Bablok fit of the of the Steelex and Pacific methods yielded the equatidn: Steelex INR = 0.85 (0.79-0.91) x Pacific INR + 0.12 (-0.02-0.21), whereas the CUSUM linearity P value was <0.01. The mean bias as determined by the Bland-Altman test was -0.156 (-0.912-0.600). Conclusion: The results obtained using Steelex reagents and the M600H coagulometer are not equivalent to those obtained using Pacific Hemostasis reagents and a Teco Coatron A4 coagulometer, at least in the therapeutic range. [ABSTRACT FROM AUTHOR]

The article presents abstracts of papers presented at the International Heart Forum in Beijing, China on September 11-13, 2009 including "Selection of Heart Valve Substitute in the Young Adult Population," by D. Loisance, "Perioperative Haemostsis and vWF in Cardiovascular Surgery," by H. S. Ao, and "Correlation between TCM Syndrome of CHD and CAG Results," by F. J. Li and colleagues.

Background: The concept of developmental hemostasis has been universally accepted. Physiological reference ranges for coagulation tests are available for infants and children of different ages. However, on Oriental children they are rare. Methods: Results of preoperative activated partial thromboplastin time (APTT) in neonates, infants, children aged 1–18 years and adults with minor elective surgery in a university affiliated hospital were reviewed retrospectively. Plasma activity of factors VIII, IX, XI, XII (FVIII:C, FIX:C, FXI:C, FXII:C) and lupus anticoagulants (LAC) in 47 children with prolonged APTT and 34 adult controls were measured to investigate the causes of prolongation. Results: Compared with adults, APTT values were prolonged significantly and were age-dependent in children, especially in neonates and infants aged 1–6 months. Mean values for FXII:C and FIX:C in children with prolonged APTT values were significantly lower than those in adults (p<0.001). Prolonged APTT values correlated negatively with FXII:C and FIX:C, and weakly with the LAC Screen ratio (LAC-SR) (r0.01=−0.808, –0.705 and 0.372, p=0.000, 0.000 and 0.001, respectively). There was weak negative correlation between FXII:C and LAC-SR (r0.01=−0.277, p=0.012). No significant correlation was seen between prolonged APTT values and FVIII:C or FXI:C. Conclusions: APTT values change dynamically with age during childhood and display a distinct pattern of evolution in children. Lower values of FXII:C and FIX:C, and presence of LAC contribute to the prolongation of APTT values in Chinese children. Clin Chem Lab Med 2009;47:1531–7. [ABSTRACT FROM AUTHOR]

Zanthoxylum nitidum (Roxb.) DC. (Z. nitidum), which is known in China as Liang – Mian – Zhen , is mainly distributed in southern China and is widely used in traditional Chinese medicine. It is traditionally used for treating stomach ache, toothache, rheumatic arthralgia, traumatic injury and venomous snake bites. Additional medical applications include the treatment of inflammations, various types of cancer, bacterial and viral infections, gastric and oral ulcers and liver damage. This paper aims to offer up-to-date information on the botany, traditional uses, phytochemistry, pharmacology and toxicity of Z. nitidum. This review also discussed the perspectives for possible future research on Z. nitidum. A comprehensive review was carried out on studies about Z. nitidum conducted in the past 60 years by using different resources, including Flora of China , Pharmacopoeia of the People's Republic of China and academic databases. At present, more than 150 chemical constituents have been separated and identified from Z. nitidum , most of which include alkaloids. Biological activities, including anti-inflammation, analgesia, haemostasis, anticancer and antibacterial, were determined via in vitro and in vivo studies. The variations in the efficacy of Z. nitidum can be attributed to the biological activities of its natural products, especially alkaloids. Toxicity studies on Z. nitidum are relatively few, thus requiring further study. This article generalises the current research achievements related to Z. nitidum , which is an important medicinal material in China. Some traditional uses of Z. nitidum have been assessed by pharmacological studies. Unresolved problems remain, including molecular mechanisms underlying biological activities, pharmacokinetics, toxicology and therapeutic effect, which are still being studied and explored before Z. nitidum can be integrated into clinical medicine. Image 1 [ABSTRACT FROM AUTHOR]

This study compared the laboratory indexes in 40 non-severe COVID-19 patients with those in 57 healthy controls. In the peripheral blood system of non-severe symptom COVID-19 patients, lymphocytes, eosinophils, basophils, total procollagen type 1 amino-terminal propeptide, osteocalcin N-terminal, thyroid-stimulating hormone, growth hormone, and insulin-like growth factor-binding protein 3 significantly decreased, and total protein, albumin, alanine transaminase, alkaline phosphatase, γ-glutamyl transferase, activated partial thromboplastin time, prothrombin time, fibrinogen, D-dimer, fibrinogen degradation products, human epididymal protein 4, serum ferritin, and C-reactive protein were elevated. SARS-CoV-2 infection can affect hematopoiesis, hemostasis, coagulation, fibrinolysis, bone metabolism, thyroid, parathyroid glands, the liver, and the reproductive system.

Background: The purse-string suture has been widely used for bleeding control after percutaneous interventions through arteriovenous fistula (AVF) and graft (AVG), and it requires suture removal the next day. This study aimed to introduce a simple method using a tourniquet to facilitate hemostasis following AVF or AVG sheath removal after percutaneous procedures., Methods: Data were retrospectively collected and included all the consecutive patients who received bleeding control with a tourniquet after percutaneous AVF or AVG interventions. Hemostasis was facilitated using the tourniquet technique after sheath removal., Results: A total of 1966 patients who received the tourniquet technique for bleeding control after percutaneous AVF or AVG interventions were included. Bleeding control was successfully achieved in all patients. Regarding complications, hematoma, thrombosis, and rebleeding occurred in 57 (2.9%), 11 (0.6%), and 8 (0.4%) patients, respectively. Neither pseudoaneurysm nor infection occurred in the patients. Age, gender, pre-existing diseases (including diabetes and hypertension), procedure count, sheath size, hemodialysis access type, and canalization route were similar between patients with and without complications. The primary patency rates at 6,12, 24, and 36 months were 85.0, 64.6, 53.8, and 41.6%, respectively., Conclusions: The tourniquet technique is an effective and safe approach for facilitating hemostasis after catheter-based percutaneous interventions of hemodialysis accesses.

Objective: To determine the effect of Yunnan Baiyao (YB) on hemostatic parameters measured by thromboelastography (TEG) in apparently healthy cats administered 1 capsule of YB orally twice daily for 1 week., Design: Prospective study of client-owned cats at a small animal specialty hospital., Setting: One private referral center., Animals: Twenty client-owned adult cats were prospectively enrolled., Interventions: All cats underwent echocardiographic examination by the same board-certified cardiologist to rule out occult cardiomyopathy. Blood samples were collected for analysis of baseline CBC, fibrinogen, and kaolin-activated TEG values. Cats were administered 1 capsule (250 mg/capsule) of YB twice daily orally for 1 week and the physical examination, CBC, fibrinogen, and TEG were re-evaluated. Any side effects attributed to YB were noted at this time., Measurements and Main Results: Three cats were excluded as 2 cats were identified with underlying cardiomyopathy and another cat had a cystic mass in the cranial mediastinum identified via echocardiography. Seventeen cats were treated with YB; however, 1 cat could not complete the study due to severe vomiting associated with YB administration. The remaining 16 cats completed the study, although 2 additional cats experienced transient vomiting. Yunnan Baiyao administration was associated with a significant decrease in HCT and red blood cell count, although no cat became anemic. None of the TEG parameters significantly changed compared to baseline after 1 week of YB therapy., Conclusions: The results of this study suggest YB at a dose of 1 capsule orally twice daily in cats fails to produce any significant change in hemostatic parameters as measured by TEG, although it did significantly reduce HCT and red blood cell count. Yunnan Baiyao was tolerated for most of the cats, although 3 of 17 (17.6%) cats experienced vomiting. Clinicians should be aware of these effects before considering the use of YB in cats., (© Veterinary Emergency and Critical Care Society 2019.)

Introduction: Disseminated intravascular coagulation (DIC) is a severe complication of critical conditions. There are several scoring systems used for the diagnosis of DIC, including the International Society on Thrombosis and Hemostasis (ISTH) Overt-DIC criteria, the Japanese Ministry of Health and Welfare (JMHW) criteria and the Chinese Society of Thrombosis and Hemostasis scoring system for DIC (CDSS). The objective of this prospective study was to evaluate the accuracy and predictive value of the CDSS., Materials and Methods: 1318 patients, aged 18-70 years old and suspected of DIC were enrolled from 18 hospitals across China. Participants were divided into two groups for analysis (group 1, non-hematological diseases; group 2, hematological diseases). 242 patients were excluded because of incomplete data collection and failure to follow-up., Results and Conclusions: The rates of concordance of diagnosis of DIC between the CDSS and two other scoring systems were close to 80%. The area under ROC curves of CDSS had a slight advantage when using the ISTH, JMHW criteria or prognosis as gold standard, respectively. The CDSS DIC was an independent predictor of mortality, and its odds-ratio was superior or comparable to that of the ISTH and JMHW criteria in the two groups. The CDSS DIC score also had a significant correlation with the APACHE II and SOFA score (p < 0.05). In summary, as a quantification standard of the Chinese experts' consensus, the CDSS is conducive to the standardized diagnosis of DIC because of its favorable diagnostic and prognostic utility., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: Harmonic scalpel is considered as a promising surgical tool for breast cancer, while its advantage over conventional approach is still controversial. Therefore, we performed this meta-analysis to compare the outcomes of harmonic scalpel and conventional tools in the surgery for breast cancer., Materials and Methods: Studies reporting the outcomes of harmonic scalpel and conventional technologies were systematically searched from online databases, PubMed and EMBASE up to April 30, 2018. Data were presented as odds ratio, risk ratio (RR), and mean difference (MD) with 95% confidence interval (CI)., Results: Intraoperative blood loss (I 2 = 96%, P < 0.05, MD = -68.78, 95% CI -93.31 to -44.24), seroma (I 2 = 3%, P = 0.41, RR = 0.63, 95% CI 0.46-0.86) and hematoma formation (I 2 = 0%, P = 0.64, RR = 0.41, 95% CI 0.23-0.73), drainage volume (I 2 = 89%, P < 0.05, MD = -105.33, 95% CI -161.33 to -49.33) and time (I 2 = 93%, P < 0.05, MD = -2.18, 95% CI -3.75 to -0.61), necrosis (I 2 = 35%, P = 0.20, RR = 0.37, 95% CI 0.16-0.86), surgical duration (I 2 = 79%, P < 0.05, MD = -8.49, 95% CI -16.56 to -0.43), and hospital stay (I 2 = 97%, P < 0.05, MD = -0.94, 95% CI -1.74 to -0.14) are significantly different between the two groups., Conclusions: Harmonic scalpel is superior to conventional tools in terms of decreasing intraoperative blood loss, seroma and hematoma formation, drainage volume and time, necrosis prevalence, surgical duration, and hospital stay, which should be strongly recommended in the surgery for breast cancer., Competing Interests: None

Objective: To investigate effects of metabolic acidosis on hemostasis function in trauma patients using thromboelastography analyzer., Methods: 65 critically injured patients and 19 healthy volunteers were enrolled in the study. Three samples of whole blood were collected from each patient or healthy volunteer. These three samples were acidified with 50mmol/l phosphate-buffered saline (PBS) (pH5.8) or a neutral buffer (50mmol/l phosphate, pH7.4) and acidified blood sample with target pH of 6.95, 7.15 or 7.35 was obtained respectively. These three samples with target pH value were added into thrombelastography analyzer (TEG® 5000 Thrombelastograph Hemostasis Analyzers; Haemoscope Corporation, Niles, Illinois, USA) respectively and variables of Clot time (r), Rate of clot formation (α Angle), Clot formation time (K), Coagulation Index (CI) and Maximum strength (MA) were monitored at 37°C. Besides, association between TEG® parameters and clinicopathological features was analyzed by the Pearson χ 2 test., Results: In trauma patients, all 5 thrombelastographic variables, Clot time (r), Clot formation time (K), Maximum Amplitude (MA), Rate of clot formation (α Angle) and Coagulation Index (CI), were significantly affected by blood acidification, F(1.321,83.213)=88.960, P<0.001, F(2,128)=112.738, P<0.001, F(1.199,76.748)=37.964, P<0.001, F(1.195,76.452)=16.789, P<0.001 and F(2,128)=178.674, P<0.001. Post hoc tests showed that moderate acidosis (pH7.15) significantly elongated K time (from 2.6 to 3.4min, P=0.0013) and increased α Angle (from 51.9°to 52.2°, P=0.0040). r, MA and CI were not markedly influenced under moderate acidification. Comparing to mild acidosis (pH7.15), severe acidosis (pH6.95) induced more serious impairment to hemostasis and all 5 variables was substantially affected, r (from 5.9 to 6.8min, P<0.001), K (from 3.4 to 3.9min, P<0.001), α Angle (from 52.2°to 50.8°, P=0.002), MA (from 52.9 to 51.6mm, P<0.001) and CI (from -2.3 to -4.2, P<0.001). Additionally, higher r elongation under severe acidosis was significantly associated with an increased mortality rate and transfusion requirement (P=0.019 and 0.031). In healthy volunteers, similar effects on hemostasis were detected. Inhibition ratios of thrombelastographic parameters were significantly higher in trauma patients than in healthy volunteers indicating severer impairment of metabolic acidosis to hemostasis in critically injured patients., Conclusions: The degree of metabolic acidosis in trauma patients is positively correlated to the severity of hemostasis dysfunction. Additionally, acidosis induces more serious impairment to hemostasis in trauma patients than in healthy volunteers. Moreover, acidosis-induced r time elongation is positively related to a higher death rate and increased transfusion requirement and this indicates a predictive role of TEG® variables for prognosis of traumatized patients., (Copyright © 2018. Published by Elsevier Inc.)

Background: Variations in maternal blood parameters, which are mostly induced by the physiological changes that occur during pregnancy, have been reported in different gestational periods. The use of the established reference intervals for healthy adult females leads to the misclassification of healthy pregnant women as abnormal. Our aim was to establish appropriate reference intervals for biochemical, haematological and haemostatic parameters in the first and third trimesters of pregnancy., Methods: We included 565 healthy pregnant women with normal pregnancies. Blood samples were collected for biochemical analyses, complete blood counts and coagulation analyses at 8-12 and 28-37 weeks of gestation. The median and reference intervals (the 2.5th and 97.5th values) were calculated for each parameter during pregnancy and then compared to the established reference intervals for healthy adult females., Results: Significant increases in triglyceride, total cholesterol, low-density lipoprotein cholesterol, uric acid, alkaline phosphatase, white blood cell, mean platelet volume, fibrinogen and D-dimer reference intervals and clear decreases in total protein, albumin, blood urea nitrogen, creatinine, red blood cell, haemoglobin, haematocrit, platelet counts and thrombin time reference intervals were observed during pregnancy. According to the 'n%', most changes were observed beginning in the first trimester. Compared to the established reference intervals, the greatest misclassifications were observed for ALB, ALP and D-Di., Conclusions: Changes in maternal blood parameters during pregnancy were confirmed. We recommend that the reference intervals for most blood parameters be revised to account for the gestational period.

Aims: To determine nursing skills most relevant for nurses participating in disaster response medical teams; make recommendations to enhance training of nurses who will be first responders to a disaster site; to improve the capacity of nurses to prepare and respond to severe natural disasters., Background: Worldwide, nurses play a key role in disaster response teams at disaster sites. They are often not prepared for the challenges of dealing with mass casualties; little research exists into what basic nursing skills are required by nurses who are first responders to a disaster situation. This study assessed the most relevant disaster nursing skills of first responder nurses at the 2008 Wenchuan earthquake disaster site., Method: Data were collected in China in 2008 using a self-designed questionnaire, with 24 participants who had been part of the medical teams that were dispatched to the disaster sites., Findings: The top three skills essential for nurses were: intravenous insertion; observation and monitoring; mass casualty triage. The three most frequently used skills were: debridement and dressing; observation and monitoring; intravenous insertion. The three skills performed most proficiently were: intravenous insertion; observation and monitoring; urethral catheterization. The top three ranking skills most important for training were: mass casualty transportation; emergency management; haemostasis, bandaging, fixation, manual handling., Conclusion: The core nursing skills for disaster response training are: mass casualty transportation; emergency management; haemostasis, bandaging, fixation, manual handling; observation and monitoring; mass casualty triage; controlling specific infection; psychological crisis intervention; cardiopulmonary resuscitation; debridement and dressing; central venous catheter insertion; patient care recording., (© 2011 The Authors. Journal of Advanced Nursing © 2011 Blackwell Publishing Ltd.)

Background: Recent clinical trials have shifted attention away from estrogens and toward androgens and sex hormone-binding globulin (SHBG) as potential mediators of increasing cardiovascular (CV) risk in women at midlife., Methods and Results: The correlation between reproductive hormones and CV risk factors was evaluated in a multiethnic (white, black, Hispanic, Chinese, and Japanese) sample of 3297 premenopausal and perimenopausal women. Testosterone and estradiol (E2) were evaluated along with SHBG and the free androgen index (FAI), the amount of testosterone not bound by SHBG. Low SHBG and high FAI were strongly and consistently related to elevated CV risk factors (higher insulin, glucose, and hemostatic and inflammatory markers and adverse lipids) even after controlling for body mass index (P<0.001 for all). Low levels of E2 were associated with elevated CV risk factors to a lesser degree. These observations were consistent across the 5 ethnic groups. Compared with whites, blacks had higher levels of SHBG and lower levels of FAI, and Chinese had lower levels of SHBG and higher levels of FAI., Conclusions: Low SHBG and high FAI are strongly associated with CV risk factors in racially diverse women, and thus, androgens likely play a role in the CV risk profile of perimenopausal women.

Plasma plasminogen activator inhibitor-1 (PAI) antigen, fibrinogen, factor VII, cholesterol, triglyceride (TG) and glucose were determined in 101 healthy subjects, who were divided into 10 subgroups according to age and smoking status. Factor VII and cholesterol were significantly higher in 50 healthy smokers than in the remaining 51 healthy non-smokers (p = 0.037 and 0.008, respectively). By dividing smokers and non-smokers each into 5 different age groups, we found that smoking could significantly increase PAI and/or factor VII, but not fibrinogen, in several age groups. On the other hand, age would significantly increase fibrinogen in either smokers or non-smokers, and this increase would be promoted by smoking. In conclusion, smoking could produce higher factor VII or PAI, whereas age could effect the significant increase of fibrinogen which was further promoted by smoking. Though aging cannot be avoided, smoking should be abstained especially in the old people to prevent the occurrence of thromboembolic diseases.

The role of hemostatic factors in the pathogenesis of cardiovascular disease has gained much attention recently. Information about hemostatic factors, and their age patterns is sparse for orientals. With the data collected in the Cardiovascular Disease Risk Factor Two-township Study in Taiwan, this study shows that, in general, the older the age, the stronger the tendency toward thrombosis. With advancing age, prothrombin time, activated partial thromboplastin time, and antithrombin-III level decreased steadily; but mean values of fibrinogen, factor VIIc, and factor VIIIc increased. Gender differences in the age patterns of the above factors are carefully described. Curvilinear relations between hemostatic factors and age were demonstrated for adults aged 18 and above for all hemostatic factors studied. This curvilinearity should be taken into consideration when adjusting for the effect of age in data analysis to avoid residual confounding, particularly when the age range of the study subjects is wide.