The effects of hemocoagulase in injectable form(hemocoagulating enzymatic fraction of South American snake Botrops Jararaca venom provided by Ravizza) on the control of intraocular bleeding during vitreous surgery were evaluated in rabbit eyes. Intraocular infusion solution with hemocoagulase(1 NIH thrombin unit/100 ml BSS) significantly reduced the bleeding time to 33.2 +/- 9.7 seconds. Electroretinogram b-wave and electroretinogram c-wave showed no abnormality. Infusate with hemocoagulase appeared to be a favorite agent for the control of intraocular bleeding during viteous surgery.
Batroxobin* ; Bleeding Time ; Bothrops ; Hemorrhage* ; Snakes ; Thrombin ; Venoms

Multiple agents can cause anaphylaxis in a perioperative setting. Identifying the agent responsible is essential for avoiding future adverse reactions as well as to attenuate the progression of anaphylaxis. Being able to distinguish an anaphylactic reaction from an anaphylactoid reaction would help clarify the therapeutic and medicolegal issues. Anaphylaxis generally occurs after reexposure to a specific antigen and requires the release of proinflammatory mediators from mast cells and basophils. An increased concentration of mast cell tryptase is a highly sensitive indicator of anaphylactic reactions during anesthesia. Botropase(R) is a procoagulant hemocoagulase purified from venom of Bothrops jararaca, a Brazilian viper and in wide use in patients with high risk of bleeding. We report a case of suspected anaphylaxis to Botropase(R) in a 67 years old female patient undergoing segmental resection of the liver with elevated concentration of serum mast cell tryptase.
Aged ; Anaphylaxis* ; Anesthesia ; Basophils ; Batroxobin* ; Bothrops ; Female ; Hemorrhage ; Histamine ; Humans ; Liver ; Mast Cells* ; Tryptases* ; Venoms

The effects of hemocoagulase in injectable form (hemocoagulating enzymatic fraction of South American snake Bothrops jararaca venom provided by Ravizza) on the control of intraocular bleeding during vitreous surgery were evaluated in rabbit eyes. Intraocular infusion solution with hemocoagulase (1 NIH thrombin unit/100 ml of BSS plus) significantly reduced the bleeding time. Electroretinogram b-wave and electroretinogram c-wave showed no abnormality. Infusate with hemocoagulase (1 NIH thrombin unit/100 ml of BSS plus) is not toxic to retinal tissue and appeared to be a useful agent for the control of intraocular bleeding during vitreous surgery.
Animals ; Batroxobin/*administration & dosage ; Eye Hemorrhage/*prevention & control ; Injections ; Rabbits ; Serine Endopeptidases/*administration & dosage ; *Vitrectomy/adverse effects

OBJECTIVEA first report of 3 patients who developed hypofibrinogenemia due to long-term administration of hemocoagulase.

METHODSThe clinical data of three patients with hypofibrinogenemia due to long-term administration of hemocoagulase were analyzed, and the related literature was reviewed.

RESULTSCase 1, a two-year old girl, had liver traumatic rupture and then treated with massive transfusion and fibrinogen infusion in addition to intravenous recombinant factor VIIa (two times) and hemocoagulase (2 U/d). The liver wound bleeding was soon stopped. However, her plasma fibrinogen level decreased to 0.12 g/L after continuous administration of hemocoagulase for 18 days. Case 2, a three-year old boy, had liver traumatic rupture and was treated with surgical repair, and then received hemocoagulase (2 U/d). On the 8th day, a large amount of blood was found to exude from abdominal cavity drainage tube and indwelling venous catheter, and his fibrinogen dropped to 0.24 g/L. Case 3 was a 45 year-old man who underwent a total mandibular resection because of malignant tumor, and he was given hemocoagulase (4 U/d). A continuous blood oozing was noted from his operation incision, and his fibrinogen level decreased to 0.25 g/L. All the three patients'plasma fibrinogen levels and coagulation tests returned to normal ranges after discontinuation of hemocoagulase administration and supplement of fibrinogen, and the bleeding stopped in cases 2 and 3.

CONCLUSIONLong-term use of hemocoagulase could induce hypofibrinogenemia and severe bleeding.

Afibrinogenemia ; chemically induced ; Batroxobin ; administration & dosage ; adverse effects ; Blood Coagulation ; Child, Preschool ; Female ; Fibrinogen ; analysis ; Humans ; Male ; Middle Aged

OBJECTIVETo investigate and compare the short-term outcome of patients with low-middle frequency sudden deafness treated with alone or combination treatment.

METHODSFrom August 2007 to October 2011, 205 patients with the diagnosis of low-middle frequency sudden deafness who were from 33 different clinical centers were recruited. All patients were followed up for four weeks from the initial examination. Patients were treated with steroid , Ginaton, batroxobin respectively, or Ginaton and steroid combination treatment.

RESULTSThe total effective rate was 90.73%. In Ginaton group, the total effective rate was 87.27%, 89.19% in steroid group, 87.80% in batroxobin group, and 95.83% in Ginaton and steroid group. Considering the total effective rate, there was no statistical difference between four groups (χ(2) = 7.98, P = 0.54). The clinical cure rate for steroid alone was 81.01%, Ginaton alone 76.36%, batroxobin alone 68.29%, and Ginaton and steroid combination treatment 80.56%. There were no clinically significant differences between the different treatments (P > 0.05).

CONCLUSIONSThe low-middle frequency sudden deafness tends to have a relatively favorable prognosis. The steroid played a good effect in the treatment. But different treatments either improving the microcirculation of inner ear or alleviating edema blood has undifferentiated results. Therefore the combination therapy may be more effective.

Batroxobin ; China ; epidemiology ; Combined Modality Therapy ; Drug Therapy, Combination ; Hearing Loss, Sensorineural ; Hearing Loss, Sudden ; classification ; diagnosis ; epidemiology ; therapy ; Humans

To study the effect of batroxobin(DF-521) on atherosclerosis, we divided 50 Japanese big ear rabbits into control group and high-lipid group. After the atherosclerosis model was successfully established, the high-lipid rabbits were divided into 3 groups(placebo group, treatment group 1 and treatment group 2). Batroxobin was injected in the treatment groups, and saline was injected in placebo group and control group. Getting the aorta before, inter and after treatment, dyeing the lipid, endothelium, smooth muscle, collagen fibers of the vascular plaque(the elastic fibers are of autofluorescence), we observed them with the light microscope and laser scanning confocal microscope. From the results, we found that the atherosclerotic plaque in the treatment groups, tended to be static four weeks later, but there was no obvious difference between treatment group 1 and treatment group 2. These implied that batroxobin possessed the action of stabilizing the atherosclerotic plaque, but the dosage-effect was not clear and the principle needed more study.
Animals ; Arteriosclerosis ; drug therapy ; pathology ; Batroxobin ; therapeutic use ; Disease Models, Animal ; Female ; Fibrinolytic Agents ; therapeutic use ; Male ; Rabbits

OBJECTIVE: To compare the hemostatic effects of local packing of Nasopore combined with hemocoagulase injection and local packing of Nasopore combined with saline injection for postoperative management of functional endoscopic sinus surgery by a double-blind, randomized control clinical trial. METHOD: Sixty-eight cases of chronic sinusitis needed functional endoscopic sinus surgery were randomly divided into the experimental group of 40 cases and control group of 28 cases, respectively. For the experimental group, 1 U of hemocoagulase dissolved in 0.5 ml saline was injected into Nasopore which was packed into the nasal cavity after operation. For the control group, 0.5 ml of saline was injected. The postoperative bleeding of the two groups were scored by visual analogue scale. RESULT: There was statistically significant difference between the bleeding VAS scores assessed 6 hours and the ones assessed 1, 2 and 3 days after the operation in the control group (P < 0.05). There was the statistically significant difference between the bleeding VAS scores of experimental group and control group assessed 6 h after the operation (P < 0.05). CONCLUSION The hemocoagulase may improve the hemostatic effect of Nasopore 6 hours after the operation by combined injection with Nasopore as nasal cavity packing.
Bandages ; Batroxobin ; administration & dosage ; Double-Blind Method ; Endoscopy ; Epistaxis ; therapy ; Female ; Humans ; Injections ; Male ; Nasal Cavity ; surgery ; Treatment Outcome

OBJECTIVE: The goal of this study is to analyze the clinical manifestation of obstetrical patients who refused transfusion of any blood component. Through this analysis, we could define the guideline of non-blood transfusion treatment during the obstetrical procedure. METHODS: 127 patients who visited our non-blood transfusion treatment center and had obstetrical procedures from 1 Jan. 2000 to 31 March 2006 participated in this study. They were retrospectively analyzed according to the following indexes; the reason of refusing blood transfusion, age, ratio of vaginal delivery to Cesarean section, comparison of hemoglobin level, volume of blood loss, presence of bloodless treatment, days of hospitalization, presence of blood transfusion, consequence of patient (including complications and deaths). Bloodless treatment at the hospital are medical method (recombinant human erythropoietin, Aprotinin, Hemocoagulase, Tranexamine acid, Venoferrum), Autotransfusion and Electrocauterization. RESULTS: Among 126 patients (except for 1 patient who was delivered at the other hospital), the vaginal delivery group consisted of 57, and the Cesarean operation group was 69. The most common cause of primary caesarean section was arrest disorder of cephalo-pelvic disproportion. Among 26 patients qualified for indication of transfusion, uterine atony had the highest number of patients at 16. Among the indication of transfusion, low hemoglobin level (< or =8.0 g/dL) after operation had the highest number of patients at 20. Patients qualified indication of transfusion had twice more blood loss (464.6+/-34.2 ml vs 920.5+/-214.2 ml) and two more days of hospitalization (7.6+/-0.5 day vs 9.7+/-0.6 day) compared with those of non-qualified for indication of transfusion. Nobody received direct transfusion of blood component. There were no death but acute renal failure in one patient, and DIC (disseminated intravascular coagulation) in another patient as complications. CONCLUSIONS: This study analyzed the clinical manifestations of patients who refused a blood transfusion in obstetrics. Especially, when the non-blood transfusion treatment was performed, which had been an issue in recent times, more active treatment showed less reduction of hemoglobin level than no treatment. This study also confirmed that bleeding patients can be treated by selective non-blood transfusion treatment.
Acute Kidney Injury ; Aprotinin ; Batroxobin ; Blood Transfusion ; Blood Transfusion, Autologous ; Cesarean Section ; Dacarbazine ; Erythropoietin ; Female ; Hemoglobins ; Hemorrhage ; Hospitalization ; Humans ; Obstetrics ; Pregnancy ; Retrospective Studies ; Uterine Inertia

OBJECTIVETo investigate the interactive effects between batroxobin and low molecular weight heparin (LMWH) in reducing peri-operative blood loss and coagulation function in patients who undergone the total hip replacement surgery.

METHODS240 ASA I - III patients received 4 000 IU LMWH 12 hours preoperatively before undergoing the total hip replacement operation, were randomly divided into two groups:testing group (Group A, n = 120) and control group (Group B, n = 120) receiving 2 U batroxobin or 50 mg mannitol 10 minutes before incision respectively. Perioperative blood loss, postoperative 24 hours drainage and blood routine test, prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen (FIB) were measured respectively. Deep vein thrombosis (DVT) were measured through color Doppler B-ultrasound 3 days after the operation.

RESULTSThe perioperative blood loss in Group A (422.64 ml) was less than that in Group B (667.67 ml) (P < 0.01) while red blood cell, hemoglobin, red blood cell volume and platelet were decreasing after operation in both groups but no significant difference was found between the two groups (P > 0.05). There were no drug-related adverse effects found in the two groups, neither the difference in hospitalization between the two groups (P > 0.05).

CONCLUSIONBatroxobin (2 U) could reduce the perioperative blood loss in patients with LMWH who had undergone the total hip replacement operation but did not show adverse effect on DVT.

Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; Batroxobin ; therapeutic use ; Blood Coagulation ; drug effects ; Hemorrhage ; prevention & control ; Heparin, Low-Molecular-Weight ; therapeutic use ; Humans ; Middle Aged

OBJECTIVETo analyze several methods of wound repair for deep partial thickness burn wounds retrospectively, so as to evaluate the significance of improvement of wound microcirculation on wound healing.

METHODS(1) 2,976 burn patients admitted to our department were enrolled in the study, among them 614 undertook tangential excision, 32, eschar abrasion, 86 allo-skin coverage after debridement, 1836 tropical application of silver sulfadiazine and 408 with traditional Chinese medicine (Jing Wan Hong ointment) with gauze bandage. The results of the management with different methods were compared. (2) Rat model with deep partial thickness burn was reproduced and topical application of silver sulfadiazine was given. The rats were randomly divided into control (n = 10, with normal saline injected via caudal vein within 5 minutes postburn), and treatment (n = 10, with batroxobin injected via caudal vein within 5 minutes postburn) groups. The blood flow perfusion unit in the wound skin was measured before burn and at 0.5 to 72 postburn hours by Laser Doppler. The wound healing rate, contraction rate and wound healing time in each group were calculated on 14 and 18 postburn days (PBDs). The number of hair follicles after wound healing was observed by histological method.

RESULTS(1) The burn wound treated by tangential excision healed within 2 to 3 post operation weeks (POWs), with the healing rate of 94.8% in patients with burn covering 50% - 70% TBSA and 93.4% in those with burn of 80% approximately 98% TBSA. The healing time of patients with allo-grafts coverage after eschar abrasion was 13.8 +/- 2.1 days without scar formation. The wound healing time was 18.0 +/- 2.3 day in 82 patients with allo-graft coverage after debridement, and it was 26.0 +/- 3.2 days with subeschar healing in 1658 patients with topical application of silver sulfadiazine. Infection in burn wound was encountered in most patients undergoing traditional Chinese medicine bandage treatment with wound healing time of 26.0 +/- 2.8 days in the lower extremities. (2) The blood flow perfusion unit of the rats in the treatment group was significantly higher than that in the control group (P < 0.01). The wound healing rate in treatment group on 14 and 18 PBD was obviously higher than that in the control group (P < 0.01). But the wound contraction rate in the two groups was similar (P > 0.05). The wound healing time in treatment group was much shorter than that in control group (P < 0.01). A few hair follicles remained in the dermis of the rats in the control group on 30 PBD, and the number was evidently smaller than that in the treatment group (P < 0.01).

CONCLUSIONEarly tangential excision and eschar abrasion remained better methods in the management of deep partial thickness burn wounds, as they could ameliorate burn wound infection, shorten treatment period, raise wound healing rate and quality. Application of batroxobin could accelerate wound healing rate by improving wound microcirculation in deep partial thickness burn wound.

Adult ; Animals ; Batroxobin ; therapeutic use ; Burns ; pathology ; surgery ; therapy ; Female ; Humans ; Male ; Microcirculation ; Rats ; Rats, Wistar ; Retrospective Studies ; Skin ; blood supply ; Skin Transplantation ; methods ; Wound Healing