1.Chemical constituents from Callicarpa kwangtungensis and their hemostatic activities.
Shu-Tian XUE ; Wei LIU ; Tao YUAN
China Journal of Chinese Materia Medica 2023;48(14):3815-3825
This study aims to identify the chemical constituents from Callicarpa kwangtungensis and determine their activities. MCI, ODS, and Sephadex LH-20 chromatography and semi-preparative HPLC were employed to separate the chemical constituents. A total of 15 compounds were separated, and their structures were identified on the basis of spectroscopic analysis and comparison with the data in relevant literature. Specifically, the 15 compounds were 3-O-α-L-rhamnopyranosyl-6-O-β-D-apiofuranosyl-4-O-E-caffeoyl-D-glucopyranoside(1), 3,6-O-α-L-dirhamnopyranosyl-4-O-E-caffeoyl-D-glucopyranoside(2), β-OH-forsythoside B(3), β-OH-poliumoside(4),(+)-lyoniresinol-3α-O-β-D-apiofuranosyl-(1→2)-β-D-glucopyranoside(5),(+)-lyoniresinol-3α-O-β-D-glucopyranoside(6),(-)-lyoniresinol-3α-O-β-D-glucopyranoside(7), kelampayoside A(8), descaffeoylpoliumoside(9), acteoside(10), alyssonoside(11), poliumoside(12), isacteoside(13), acetyl forsythoside B(14), and forsythoside B(15). Compounds 1 and 2 were novel, and the NMR data of compounds 3 and 4 were reported here for the first time. Furthermore, the hemostatic activities of the extract and abundant ingredients(compounds 12 and 15) of C. kwangtungensis were determined with Yunnan Baiyao as the positive control and normal saline as the negative control. The extract and compounds 12 and 15 significantly shortened the tail tip bleeding time in mice.
Animals
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Mice
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Callicarpa
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Hemostatics
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China
;
Glycosides/chemistry*
2.Clinical Observation of Traumatic hyphema.
Journal of the Korean Ophthalmological Society 1972;13(4):257-260
Authors have experienced 27 cases of traumatic hyphemas in our department for recent years. All the patients was taken systemic administration of Diamox as ocular hypotensives, prednisolone as anti-inflammatory agent and hemostatics, and antihistaminics for neutralize the histamin like substance which may emerge after vascular injury by trauma, without any surgical procedures or other medication. The result of treatment satisfactory as hyphemas were absorbed clerly within short period without any complication and visual deterioration.
Acetazolamide
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Hemostatics
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Humans
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Hyphema*
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Prednisolone
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Vascular System Injuries
3.Current situation and prospect of resource evaluation and sustainable utilization on Bletilla.
Yan-Jun ZHANG ; Wei SUN ; Yan HE ; Shu-Hui WANG ; Qing WANG ; Fang YUAN ; Lu-Lu YANG ; Qiong LIANG
China Journal of Chinese Materia Medica 2018;43(22):4397-4403
The plants of Bletilla are one of the groups in Orchidaceae with the highest economic value. As the traditional Chinese medicinal material, Bletillae Rhizoma exhibits excellent efficacy in hemostatic, antibiosis, detumescent, anticancer activities and regenerating tissue to heal wound, which has great development potential. However, Bletillae Rhizoma is mainly collected from wild resources. At present, the quantity of wild resources of Bletilla plants has sharply decreased and is far from meeting the needs. Resource appraisal and breeding and cultivation of excellent germplasms of Bletilla plants are important for scientific utilization of the resources of the genus. This paper reviewed the following researches of Chinese Bletilla resources: species and distribution, genetic diversity, active ingredient evaluation, breeding, as well as seeding production and cultivation techniques. Suggestions were also provided in further researches on the resources evaluation, sustainable development and efficient utilization of Chinese Bletilla plants.
Drugs, Chinese Herbal
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Hemostatics
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Orchidaceae
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Plant Breeding
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Plants, Medicinal
;
Rhizome
4.Trauma-induced coagulopathy: Mechanisms and clinical management.
Vui Kian HO ; Jolin WONG ; Angelly MARTINEZ ; James WINEARLS
Annals of the Academy of Medicine, Singapore 2022;51(1):40-48
INTRODUCTION:
Trauma-induced coagulopathy (TIC) is a form of coagulopathy unique to trauma patients and is associated with increased mortality. The complexity and incomplete understanding of TIC have resulted in controversies regarding optimum management. This review aims to summarise the pathophysiology of TIC and appraise established and emerging advances in the management of TIC.
METHODS:
This narrative review is based on a literature search (MEDLINE database) completed in October 2020. Search terms used were "trauma induced coagulopathy", "coagulopathy of trauma", "trauma induced coagulopathy pathophysiology", "massive transfusion trauma induced coagulopathy", "viscoelastic assay trauma induced coagulopathy", "goal directed trauma induced coagulopathy and "fibrinogen trauma induced coagulopathy'.
RESULTS:
TIC is not a uniform phenotype but a spectrum ranging from thrombotic to bleeding phenotypes. Evidence for the management of TIC with tranexamic acid, massive transfusion protocols, viscoelastic haemostatic assays (VHAs), and coagulation factor and fibrinogen concentrates were evaluated. Although most trauma centres utilise fixed-ratio massive transfusion protocols, the "ideal" transfusion ratio of blood to blood products is still debated. While more centres are using VHAs to guide blood product replacement, there is no agreed VHA-based transfusion strategy. The use of VHA to quantify the functional contributions of individual components of coagulation may permit targeted treatment of TIC but remains controversial.
CONCLUSION
A greater understanding of TIC, advances in point-of-care coagulation testing, and availability of coagulation factors and fibrinogen concentrates allows clinicians to employ a more goal-directed approach. Still, hospitals need to tailor their approaches according to available resources, provide training and establish local guidelines.
Blood Coagulation Disorders/therapy*
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Blood Transfusion
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Hemorrhage
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Hemostasis
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Hemostatics
;
Humans
5.Absorbable Hemostatic Material with High Water Absorption Based on Polysaccharide.
Chinese Journal of Medical Instrumentation 2022;46(1):28-33
An absorbable hemostatic material based on polysaccharide was prepared. The concentration of blood cells and coagulation factors was increased by reducing the water content in the blood, so as to reduce the coagulation time and achieve the purpose of rapid hemostasis. The specific surface area of starch was increased by using hydrochloric acid to hydrolyze potato starch, which made it easier to combine with α-amylase and increased the degradation rate. Starch was crosslinked into microspheres by crosslinking agent, which made the particle size uniform and greatly improved the water absorption. The surface modification of crosslinked starch microspheres with carboxymethyl group can further improve the water absorption of hemostatic materials. The results showed that the water absorption rate of our hemostatic material was more than 800%, and the average hemostatic time in the animal model was 138.7s. Compared with the imported products on the market, our hemostatic material have better hemostatic performance.
Animals
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Hemostasis
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Hemostatics/pharmacology*
;
Polysaccharides/pharmacology*
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Starch/pharmacology*
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Water/pharmacology*
6.Evaluation of self-prepared absorbable hemostatic cellulose fibrils.
Lingshuang WANG ; Jianxing TONG ; Zhezhe ZHAO ; Xiaochun YANG
Journal of Zhejiang University. Medical sciences 2021;50(5):633-641
To evaluate the effectiveness and safety of self-prepared absorbable hemostatic fibrils.A kind of absorbable hemostatic fibrils were prepared by self-developed patent technique. The physical form and molecular structure of the fibrils and a marketed product Surgicel were characterized by general observation and infrared spectroscopy; the carboxyl content, pH value and relative molecular mass of fibrils were determined by potentiometric titration method, pH meter and copper ethylenediamine method, respectively. The behavior of the fibrils and Surgicel in contact with blood was observed by inverted microscope, the cytotoxicity was evaluated by agarose diffusion cell assay . The external iliac artery hemorrhage model and the back muscle infiltration model in rats were established. The hemostatic effectiveness of the fibrils was investigated by hemostasis time and blood weight, and the degradation and biosafety of fibrils were investigated by observation photography, immune organ weighing, hematology and coagulation index measuring, and histopathological examination. The fibrils and Surgicel had similar molecular structures. Compared with the raw material regenerated cellulose, the typical carboxyl stretching vibration absorption peak of -COOH appeared near in both fibrils and Surgicel. The carboxyl content of the two materials was about 20%, and the pH value was about 3. The relative molecular mass of the fibers after oxidation was 4466±79, which was close to that of Surgicel(>0.05). After contacting with blood, the volume of fibrils and Surgicel expanded, and absorbed blood of dozens of times as their own weight. The results of agar diffusion test showed that the fibrils had no cytotoxicity. The results of animal experiments showed that the hemostasis completed within and there was no significant difference in blood weight and speed of hemostasis between two products (both >0.05). The fibrils could be degraded 1 week after being implanted to the bleeding sites of the muscle. There were no pathological effects on the appearance, body weight, food intake, immunological tissue thymus, spleen, lymph nodes, hematology and coagulation indexes of the rats, and no obvious abnormality found in the histopathological examination. The prepared absorbable hemostatic fibrils have excellent biological safety and effectiveness.
Animals
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Cellulose/pharmacology*
;
Hemostasis
;
Hemostatics/pharmacology*
;
Rats
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Spleen
7.Research and Application Progress of Chitosan-based Hemostatic Materials---Review.
Journal of Experimental Hematology 2021;29(5):1685-1689
Whether in war or peace, timely, effective and accurate hemostasis is an important measure to improve the survival rate and cure rate of the wounded. All the countries in the world are actively developing different types of hemostatic materials so as to reduce the amount of bleeding in an emergency and create favorable conditions for subsequent transport and treatment. At present, the commercialized hemostatic materials are mainly divided into natural biological, synthetic biological, mineral and coagulation components, but all these materials have their own limitations. In this article, the characteristics of chitosan and its derivatives are reviewed as the representatives of the natural organic macromolecular polysaccharide hemostasis materials. Their molecular structures, biomedical properties, domestic and foreign research and application progress as well as comparison with applications of other hemostatic materials are involved. The further research is prospected for optimization and innovation to develop composite chitosan hemostatic materials with the function of hemostasis, antibiosis, pain relief and promoting wound healing.
Blood Coagulation
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Chitosan/pharmacology*
;
Hemorrhage
;
Hemostasis
;
Hemostatics
;
Humans
8.Research Progress of Carboxymethyl Chitosan-Based Haemostatic Materials and Their Haemostatic Mechanism --Review.
Kang REN ; Li-Hao WU ; Ling XU
Journal of Experimental Hematology 2023;31(3):911-915
Effective haemostatic materials can quickly control bleeding and achieve the purpose of saving patients' lives. In recent years, chitosan-based haemostatic materials have shown good haemostatic effects, but their application is limited because chitosan is almost insoluble in water. Carboxymethyl chitosan-based haemostatic materials can promote hemostasis by activating red blood cells and aggregating platelets. In addition, carboxymethyl chitosan can bind with Ca2+ to activate platelets and coagulation factors, and start endogenous coagulation pathways, which can adsorb fibrinogen in plasma to promote haemostasis. In this paper, the latest research progress of carboxymethyl chitosan-based haemostatic materials and their haemostatic mechanism were reviewed, in order to further strengthen the understanding of the haemostatic mechanism of carboxymethyl chitosan-based haemostatic materials, and provide new idea for the research and clinical application of carboxymethyl chitosan-based haemostatic materials.
Humans
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Hemostatics
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Chitosan/pharmacology*
;
Hemostasis
;
Blood Coagulation/physiology*
;
Hemorrhage
9.Why Cannot Suction Drains Prevent Postoperative Spinal Epidural Hematoma?.
Dong Ki AHN ; Won Shik SHIN ; Jin Woo KIM ; Seong Min YI
Clinics in Orthopedic Surgery 2016;8(4):407-411
BACKGROUND: Postoperative spinal epidural hematoma (POSEH) is different from spontaneous or post-spinal procedure hematoma because of the application of suction drains. However, it appeared that suction drains were not effective for prevention of POSEH in previous studies. The purpose of this study was to test our hypothesis that POSEH can be caused by hypercoagulability. METHODS: This was an experimental study. One hundred fifty milliliters of blood was donated from each of the 12 consecutive patients who underwent spine surgery and infused into 3 saline bags of 50 mL each. One of the 3 bags in each set contained 5,000 units of thrombin. All of them were connected to 120 ± 30 mmHg vacuum suctions: drainage was started 8 minutes after connection to the vacuum system for 12 normal blood bags (BV8) and 12 thrombin-containing blood bags (TBV8) and 15 minutes after connection for the remaining 12 normal blood bags (BV15). The amount of initial and remaining hematoma at 20 minutes, 120 minutes, and 24 hours after vacuum application were measured by their weight (g). The primary endpoint was the difference between BV8 and TBV8. The secondary end point was the difference between BV8 and BV15. RESULTS: The remaining hematoma in TBV8 was significantly greater than that in BV8 at all measurement points: 46.3 ± 12.4 vs. 17.0 ± 1.3 (p = 0.000) at 20 minutes; 33.0 ± 8.2 vs. 16.3 ± 1.2 (p = 0.000) at 120 minutes; and 26.1 ± 4.0 vs. 15.8 ± 1.6 (p = 0.000) at 24 hours after vacuum application. The remaining hematoma of BV15 was significantly greater than that of BV8 at all measurement points: 30.0 ± 12.0 vs. 17.0 ± 1.3 (p = 0.002) at 20 minutes; 24.2 ± 7.6 vs. 16.3 ± 1.2 at 120 minutes (p = 0.002); and 22.2 ± 6.6 vs. 15.8 ± 1.6 (p = 0.004) at 24 hours after vacuum application. CONCLUSIONS: With a suction drain in place, the amount of remaining hematoma could be affected by coagulability. Thrombin-containing local hemostatics and the length of time elapsed before the commencement of suction resulted in hypercoagulability, indicating these two factors could be causes of POSEH.
Drainage
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Hematoma
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Hematoma, Epidural, Spinal*
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Hemostatics
;
Humans
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Spine
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Suction*
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Thrombin
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Thrombophilia
;
Vacuum
10.Biologic response of local hemostatic agents used in endodontic microsurgery.
Youngjune JANG ; Hyeon KIM ; Byoung Duck ROH ; Euiseong KIM
Restorative Dentistry & Endodontics 2014;39(2):79-88
Appropriate use of local hemostatic agent is one of the important factors on the prognosis of endodontic microsurgery. However, most investigations to date focus on the hemostatic efficacy of the agents, whereas their biologic characteristics have not received enough attention. The purpose of this paper was to review the biologic response of local hemostatic agents, and to provide clinical guidelines on their use during endodontic microsurgery. Electronic database (PUBMED) was screened to search related studies from 1980 to 2013, and 8 clinical studies and 18 animal studies were identified. Among the materials used in these studies, most widely-investigated and used materials, epinephrine, ferric sulfate (FS) and calcium sulfate (CS), were thoroughly discussed. Influence of these materials on local tissue and systemic condition, such as inflammatory and foreign body reaction, local ischemia, dyspigmentation, delayed or enhanced bone and soft tissue healing, and potential cardiovascular complications were assessed. Additionally, biological property of their carrier materials, cotton pellet and absorbable collagen, were also discussed. Clinicians should be aware of the biologic properties of local hemostatic agents and their carrier materials, and should pay attention to the potential complications when using them in endodontic microsurgery.
Animals
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Calcium Sulfate
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Collagen
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Epinephrine
;
Foreign-Body Reaction
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Hemostatics
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Ischemia
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Microsurgery*
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Population Characteristics
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Prognosis