Objective To investigate the coagulation and fibrinolytie system changes in liver cirrhosis (LC) patients with and without portal vein thrombosis (PVT). Method Twenty-six cases of LC with PVT (PVT group) and 61 eases of LC without PVT (control group) were chosen. Platelet(Pt), prothrpmbin time (PT), activated partial thromboplastin time (APTT), fibrin (Fib), D-dimer, tissue plasminogen activator (t-PA) and plasminogen activator inhibitor-1 (PAI-l) were determined. SPSS 11.5software was used for statistic analysis. Results In PVT group, the average level of D-dimer was (0.97±0.53 ) mg/L,signifieantly higher than that in control group (0.61±0.40) mg/L. No significant difference was found between the two groups in Pt PT, APTT, Fib, t-PA and PAI-1. PT and APTT were progressively prolonged from Child-Pugh grade A to B and then to C. Fib was progressively decreased from Child-Pugh grade A to B and then to C. Decreased Pt and increased t-PA, PAI-1 were found in LC patients, but had no sighifieant difference. Conclusions The changes determined of coagulation and fibrinolytie system in patients with LC are abnormal. The average level of D-dimer is higher in LC patients with PVT than that in LC patients without PVT. D-dimer may be a helpful tool to rule out the presence of an underlying PVT in LC patients.

There has been no consensus on the efficacy of extracranial-intracranial arterial bypass (EIAB) for ischemic cerebrovascular disease. As an important factor in the pathophysiologic mechanisms of ischemic cerebrovascular disease, the changes of cerebral hemodynamics have received attention. The article expounds the clinical significance of EIAB from the point of view of cerebral hemodynamics, particularly presents its preoperative assessment, operative procedures, and efficacy criterion.

Objective To investigate the relationship between carotid arteries atherosclersis and subclinical hypothyroidism in patients with type 2 diabetes mellitus (T2DM).Methods From January to December 2010,408 patients with T2DM were enrolled in this study.The patients were divided into euthyroidism group (376 patients) and subclinical hypothyroidism group (32 patients).The incidence of carotid arteries atherosclerosis in two groups was compared and the risk factors were analyzed by Logistic regression analysis in patients with T2DM.Results There was no significant difference in age,course of disease,body mass index,fasting plasma glucose,total cholesterol,high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol,triacylglycerol and glycosylated hemoglobin between two groups (P ＞ 0.05).The incidence of carotid arteries atherosclerosis in subclinical hypothyroidism group was higher than that in euthyroidism group [81.2％ (26/32) vs.61.4％ (231/376)],and the difference was significant (P =0.026).Logistic regression analysis showed that age and thyroid stimulating hormone (TSH)were risk factors (OR =1.178 and 1.227,P =0.000 and 0.019) and HDL-C was protective factor (OR =0.284,P =0.003) in T2DM with carotid arteries atherosclerosis.Conclusion Higher incidence of carotid arteries atherosclerosis is found in T2DM patients with subclinical hypothyroidism and increased TSH are independent risk factors that has not previously been described.

Objective To investigate the changes of C-reactive protein(CRP)and D-dimer in the patients with hyperlipidemic acute pancreatitis(HLAP)and biliogenic acute pancreatitis(BAP).Methods One hundred fifty-five inpatients with acute pancreati-tis in our hospital from Jan.2012 to Dec.2014 were divided into the HLAP group and BAP group by etiology.Also the patients were divided into mild acute pancreatitis(MAP)subgroup and moderately severe acute pancreatitis(MSAP)subgroup by disease se-verity.Blood routine,liver and kidney function,glucose(Glu),calcium,blood lipids,CRP and D-dimer were measured.Results Platelet,Glu and blood lipid indicators in the HLAP group were significantly higher than those in the BAP group.But alanine amin-otransferase(ALT),r-glutamyl transferase(GGT),alkaline phosphatase(ALP),total bilirubin(TBIL),direct bilirubin(DBIL),calci-um(Ca)and creatinine(Cr)in the HLAP group were significantly lower than those in the BAP group(P <0.05).CRP in the HLAP group was significantly higher than that in the BAP group with statistical difference(P <0.01).CRP had statistical difference be-tween the HLAP group and BAP group in the MAP and MSAP subgroups (P <0.01).CRP and D-dimer had statistical difference between in the MAP and MSAP subgroups of the HLAP group(P <0.05).Increased CRP and D-dimer in the HLAP group were the risk factors for MSAP occurrence(OR =1.121,3.716,P =0.025,0.001 ).In the BAP group,only increased D-dimer was the risk factor for MSAP occurrence(OR=2.717,P =0.002).Conclusion CRP and D-dimer in HLAP and BAP are increased with dis-ease severity aggravation,moreover CRP increase is more obvious in HLAP patients.

Objective To investigate the coagulation and anticoagulation changes in liver cirrhosis(LC)patients with and without portal vein thrombosis(PVT).Methods Patients with LC during 2006 to 2007 in our hospital were reviewed and twenty cases of LC with PVT were included in the study.Forty cases of LC without PVT were chosen as controls.PVT was confirmed by dynamic abdominal computed tomography.Using an analyzer and following manufacturer instructions,we determined PT,APTT,Fib,Antithrombin Ⅲ and Protein S.SPSS software was used for statistic analysis.Results In PVT group,the average level of PS and AT-Ⅲ were(18.68?3.14)mg/L and(94.65?7.96)%,significantly lower than(20.44?3.04)mg/L and(100.26?9.27)% in controls.No difference was found between patients with or without PVT in PT、APTT、Fib.PT and APTT were progressively prolonged from A to B and then to C.Fib and AT-Ⅲ were progressively decreased from A to B and then to C.Low levels of PS was found in LC patients.Conclusion The changes of coagulation and anticoagulation in patients with LC dearly exist.The average level of PS and AT-Ⅲ in PVT group is significantly lower than controls.PS and AT-Ⅲ may play a pathogenetic role in the development of PVT.

Objective To investigate the correlation and differences of serum calcium ( Ca) and intact parathyroid hormone ( i-PTH) in patients with hyperlipidemic or biliogenic acute pancreatitis ( AP) .Methods From Jan 2012 to Jan 2014 , total 80 AP patients admitted to Bejing Chaoyang Hospital were enrolled . According to the etiology , AP patients were divided into 2 groups, hyperlipidemic acute pancreatitis ( HLAP) group and biliogenic acute pancreatitis (BAP) group.Blood routine, function of liver and kidney , blood lipids, Ca, and i-PTH were measured .Differences between Ca and i-PTH in HLAP group and BAP group were analyzed, and found the correlation with disease severity of AP .Results 80 AP patients included 43 HLAP and 37 BAP patients, 55 mild acute pancreatitis(MAP) and 25 moderately severe acute pancreatitis (MSAP) patients.HLAP group had 34 male and 9 female patients, average age was 37 years, 31 MAP and 12 MSAP patients.BAP group had 17 male and 20 female patients, average age was 58 years, 24 MAP and 13 MSAP patients.proportion of males was significantly higher in HLAP group than BAP group .on the contrary, average age was significantly lower (P<0.01 and <0.01, respectively).No significantly difference was found in MAP/MSAP ration.Level of serum Ca in HLAP group was significantly decreased than BAP group (1.92 ± 0.24 mmol/L vs 2.14 ±1.99 mmol/L, P<0.05).No significantly difference was found in i-PTH between two groups.Level of serum Ca in MAP and MSAP subgroup in HLAP group were 1.98 ±0.20 mmol/L and 1.76 ± 0.27 mmol/L.Accordingly, Level of serum Ca were 2.23 ±0.15 mmol/L and 1.98 ±0.19 mmol/L in BAP group. i-PTH in MAP and MSAP subgroup in HLAP group were 43.41 ±18.40 ng/L and 56.07 ±33.61 ng/L.Accordingly, i-PTH was 39.22 ±17.19 mmol/L and 52.73 ±29.42 mmol/L in BAP group.Compared to MAP, Ca in MSAP group was significantly decreased in HLAP and BAP group ( P<0.01 and <00.5, respectively).In HLAP group, Ca was a negative correlation with low density lipoprotein cholesterol (LDLC-) and triglycerides(TG) (P<0.05 and <0.01, respectively).In BAP group, Ca was a negative correlation with i-PTH(P<0.05).Conclusions Serum Ca is decreased with severity of HLAP and BAP .Decreased Ca has correlation with increased LDL-C, TG in HLAP and increased i-PTH in BAP.

Objective To investigate the relationship of thyroid hormone (TH), thyroid stimulating hormone (TSH) and blood calcium in hyperlipidemic acute pancreatitis (HLAP) patients. Methods Fifty patients with HLAP were selected, among whom 37 patients with mild acute pancreatitis (MAP) were enrolled into MAP group, and 13 patients with moderately severe acute pancreatitis (MSAP) were enrolled into MSAP group. The albumin, blood glucose, creatinine, blood lipids, blood calcium, free tri-iodothyronine (FT3), free thyroxine (FT4) and TSH levels were measured and analyzed. Results The blood calcium, FT3 and TSH levels in MAP group were significantly higher than those in MSAP group:(2.02 ± 0.26) mmol/L vs. (1.75 ± 0.27) mmol/L, (1.88 ± 0.46) ng/L vs. (1.52 ± 0.35) ng/L and (0.28 ± 0.20) mU/L vs. (0.17 ± 0.12) mU/L, but the blood glucose and triglycerides (TG) levels were significantly lower than those in MSAP group: (13.36 ± 5.83) mmol/L vs. (19.99 ± 7.97) mmol/L and (24.01±12.46) mmol/L vs. (34.76 ± 20.39) mmol/L, and there were statistical differences (P<0.01 or<0.05). There were no statistical differences in albumin, creatinine, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol (LDL-C) and FT4 levels between 2 groups (P>0.05). The correlation analysis result showed: in patients with HLAP, TSH and albumin had a positive correlation with blood calcium (r=0.344 and 0.372, P=0.014 and 0.008), LDL-C and TG had negative correlation with blood calcium (r=-0.315 and-0.444, P=0.026 and 0.001), and other indexes had no correlation with blood calcium (P>0.05). Conclusions Blood calcium, FT3 and TSH levels are decreased with severity of HLAP. Decreased blood calcium may be one of reasons for decreased TSH in HLAP patients.

Objective To study the relationship between fibrinolysis,anticoagulation system indexes and serum albumin (ALB) in patients with liver cirrhosis.Methods One hundred and thirty-seven patients with liver cirrhosis were enrolled.Serum ALB,D-dimer (D-D),tissue plasminogen activator (t-PA),plasminogen activator inhibitor-1 (PAI-1),protein C (PC),protein S (PS) and antithrombin-Ⅲ (AT-Ⅲ) levels were measured.Results D-D level was increased with deterioration of liver function.D-D levels were (0.38 ± 0.24),(0.58 ± 0.43) and (0.90 ± 0.55) mg/L in Child-Pugh class A,B and C,respectively.PC,PS and AT-Ⅲ levels were decreased with deterioration of liver function.PC levels were (3.29 ± 1.04),(2.50 ± 1.27) and (2.29 ± 1.05)mg/L in Child-Pugh class A,B and C,respectively.PS levels were (20.74 ± 5.91),(17.97 ± 5.26) and (17.79 ± 5.12) mg/L,respectively.AT-Ⅲ levels were (104.62 ± 8.59)％,(101.76 ± 10.08)％ and (92.91 ± 10.48)％,respectively.D-D showed negative correlation with ALB (r =-0.402,P ＜ 0.01).On the contrary,PC,PS and AT-Ⅲ levels showed positive correlation with ALB (r =0.266,0.286 and 0.405,P ＜0.01).Conclusions Fibrinolysis and anticoagulation system indexes are changed with deterioration of liver function and are related with ALB directly.The indexes may be a helpful tool to evaluate the liver function in patients with liver cirrhosis.

feature of GD that has not previously been described.

Objective To investigate the relationship between thrombomodulin(TM), fibrinolytic system changes and the score of the model for end-stage liver disease(MELD)in liver cirrhosis patients.Methods Eighty-five liver cirrhosis patients admitted from January 2008 to December 2009 were included in this study. TM, D-dimer, tissue plasminogen activator(t-PA), plasminogen activator inhibitor -1(PAI-1),serum creatinine, serum total bilirubin and international normalized ratio(INR)on all patients were measured and then the score of the MELD was calculated. Results The score of the MELD was 1-29(11.35 ± 6.02)scores. The score of the MELD ≤ 9 scores was 40 cases(47.1%), 10- 19 scores was 32 cases (37.6%),20-29 scores was 13 cases(15.3%).TM and D-dimer were progressively increased with MELD score. There was significant difference among the three groups(P＜0.01). The levels of TM and D-dimer had positive correlation with the score of the MELD(r = 0.706,0.425,P ＜ 0.01). Conclusions The levels of TM and D-dimer have positive correlation with the score of the MELD in liver cirrhosis patients. These indices can help predicting the degree of liver function disorder and prognosis.