PURPOSE: To compare the effect of apixaban and low molecular weight heparin (LMWH) in the prevention and treatment of deep venous thrombosis (DVT) after total knee arthroplasty in older adult patients. MATERIALS AND METHODS: A total of 220 patients (average age of 67.8±6.4 years) undergoing total knee arthroplasty were randomly selected as research subjects and were divided into apixaban and LMWH groups (110 in each group). RESULTS: The incidence of DVT was lower in the apixaban group than in the LMWH group (5.5% vs. 20.0%, p=0.001). Activated partial thromboplastin times (35.2±3.6 sec vs. 33.7±2.2 sec, p=0.010; 37.8±4.6 sec vs. 34.1±3.2 sec, p<0.001; 39.6±5.1 sec vs. 35.7±3.0 sec, p=0.032) and prothrombin times (14.0±1.0 sec vs. 12.8±0.9 sec, p<0.001; 14.5±1.2 sec vs. 13.0±1.1 sec, p<0.001; 15.3±1.4 sec vs. 13.2±1.3 sec, p=0.009) in the apixaban group at 1 week after surgery, 3 weeks after surgery, and the end of treatment were higher than those in the LMWH group. Platelet and fibrinogen levels in the apixaban group were lower than those of the LMWH group. Also, capillary plasma viscosity and erythrocyte aggregation in the apixaban group at 1 week after surgery, 3 weeks after surgery, and the end of treatment were lower than those in the LMWH group. CONCLUSION: Apixaban, which elicits fewer adverse reactions and is safer than LMWH, exhibited better effects in the prevention and treatment of DVT after total knee arthroplasty in older adults.
Adult ; Arthroplasty, Replacement, Knee ; Blood Platelets ; Capillaries ; Erythrocyte Aggregation ; Fibrinogen ; Heparin, Low-Molecular-Weight ; Humans ; Incidence ; Plasma ; Prothrombin Time ; Research Subjects ; Thromboplastin ; Venous Thrombosis ; Viscosity

The circulatory system is closely related to the inter-relationship between the anatomy of the heart and blood vessels, and the fluid dynamic properties of blood. The physical properties of blood, which affect blood flow, are called hemorheologic factors. Hemorheologic factors, such as blood viscosity and erythrocyte aggregation, are influenced mainly by hematocrit. A higher hematocrit level results in an increase in blood viscosity, erythrocyte aggregation, which impedes the circulation itself, and tissue oxygenation. An excess of serum ferritin causes injury to vascular endothelial cells and erythrocytes via oxygen free radicals. In addition, an excess of blood can aggravatee the adverse effects of the hemorheologic parameters and induce atherogenesis, microcirculatory disturbances, and major cardiovascular events. A preventive and therapeutic approach with a phlebotomy or blood donation has been stimulated by the knowledge that blood loss, such as regular donations, is associated with significant decreases in key hemorheologic variables, including blood viscosity, erythrocyte aggregation, hematocrit, and fibrinogen. Major cardiovascular events have been improved in regular blood donors by improving blood flow and microcirculation by decreasing the level of oxidative stress, improving the hemorheologic parameters, and reducing the serum ferritin level. Confirmation of the positive preventive and therapeutic effects of blood donations on cardiovascular disease by a well-designed and well-controlled Cohort study may be good news to patients with cardiovascular disease or at risk of these diseases, as well as patients who require a transfusion.
Atherosclerosis ; Blood Donors* ; Blood Vessels ; Blood Viscosity ; Cardiovascular Diseases ; Cohort Studies ; Endothelial Cells ; Erythrocyte Aggregation ; Erythrocytes ; Ferritins ; Fibrinogen ; Free Radicals ; Heart ; Hematocrit ; Humans ; Hydrodynamics ; Microcirculation ; Oxidative Stress ; Oxygen ; Phlebotomy ; Therapeutic Uses

The combination of Danggui and Honghua (GH) is a popular herb pair commonly used in clinic for the treatment of blood stasis syndrome in China. To evaluate the activating blood circulation and dissipating blood stasis effects of the combination of different proportions of Danggui and Honghua on acute blood stasis rats, and optimize the proportion of GH to have the best activating blood circulation and dissipating blood stasis effect. Acute blood stasis rat model was induced by subcutaneous injection of adrenaline and ice water bath. The blood stasis rats were administrated intragastrically with GH (1 : 0, 4 : 1, 2 : 1, 3 : 2, 1 : 1, 2 : 3, 1: 2, 1 : 4 and 0 : 1) extracts. The whole blood viscosity (WBV), plasma viscosity (PV), and high shear whole blood relative index (HSWBRI), low shear whole blood relative index (LSWBRI), and erythrocyte aggregation index (EAI) were tested to observe the effects of GH on hemorheology of blood stasis rats. And the maximum aggregation induced by adenosine diphosphate (ADP) was tested to observe the effect of GH on platelet aggregation index of blood stasis rats. In addition, the prothrombin time (PT), thrombin time (TT), activated partial thromboplastin time (APTT) and plasma fibrinogen (FIB) were tested to observe the effects of GH on blood coagulation function of blood stasis rats. Then principal component analysis and multi-attribute comprehensive index methods were both used to comprehensively evaluate the total activating blood circulation and dissipating blood stasis effects of GH. The results showed that the hemorheological indexes and coagulation parameters of model group both had significant differences with normal group. Compared with model group, GH (1 : 0, 4 : 1, 2: 1, 3 : 2, 1 : 1, 2 : 3, 1 : 2, 1 : 4 and 0 : 1) could improve all the blood hemorheology indexes and regulate part indexes of blood coagulation function and platelet aggregation in acute blood stasis rats. Based on principal component analysis and multi-attribute comprehensive index methods, GH 1 : 1 and GH 3 : 2 both had the best effect of blood circulation and dissipating blood stasis, and the effect of GH 1 : 1 was slightly better than GH 3 : 2. These results suggest that GH could obviously ameliorate the abnormality of hemorheology and blood coagulation function in acute blood stasis rats. The optimized proportion of GH was consistent with regulations of medicine usage that GH 1 : 1 had the highest frequency used in traditional Chinese formulae. It could provide scientific basis for more effective application of the compatibility between Danggui and Honghua in modern clinic medicine.
Animals ; Blood Coagulation ; Blood Viscosity ; Carthamus tinctorius ; China ; Drugs, Chinese Herbal ; pharmacology ; Erythrocyte Aggregation ; Hemorheology ; Partial Thromboplastin Time ; Platelet Aggregation ; Principal Component Analysis ; Prothrombin Time ; Rats ; Rats, Sprague-Dawley ; Thrombin Time

This article summarizes the pathogenesis of hypercoagulability in β thalassemia patients, including platelet activation, alteration of red blood cell membranes, abnormal expression of adhesion molecules on vascular endothelial cells and iron overload. Clinical evidence, clinical manifestations of hypercoagulable state and thrombosis in β thalassemia and the effect of splenectomy on hypercoagulable state were reviewed. Strategies to prevent and treat the thromboembolic events in β-thalassemia intermedia are also discussed, including transfusion therapy to raise hemoglobin levels, avoidance or delay of splenectomy and a number of treatments in the exploration.
Erythrocyte Aggregation ; Humans ; Thrombophilia ; etiology ; prevention & control ; beta-Thalassemia ; complications

OBJECTIVETo observe blood flow features in elderly hypertension patients of different Chinese medical syndrome types and to test their correlation with rheological properties of red blood cells (RBCs) by applying micro-channel array flow analyzer (MC-FAN).

METHODSRecruited were 109 elderly hypertension patients were assigned to phlegm-stasis blocking collateral group (35 cases), yin deficiency yang hyperactivity group (42 cases), Shen deficiency group (32 cases) according to Chinese medical syndrome typing. Besides, another 21 elderly healthy subjects were recruited as the control group. The hemorheology visualization testing of elderly hypertension patients was detected using MC-FAN. The erythrocyte deformation index (DI), erythrocyte aggregation index (EAI), and erythrocyte related plasma ATPase activity were observed. The correlation between the transiting time (TT) of blood hemorheology visualization and rheological indicators of RBCs were analyzed.

RESULTSThe hemorheology visualization TT was significantly prolonged more in the phlegm-stasis blocking collateral group than in the yin deficiency yang hyperactivity group, the Shen deficiency group, and the control group (P < 0.05). Compared with the control group, the DI was significantly lower in the phlegm-stasis blocking collateral group than in the yin deficiency yang hyperactivity group, the Shen deficiency group, and the control group (P < 0.05) when the shear rate was 100 s(-1). Compared with the control group, the plasma Na+ -K(+) -ATPase activity and the plasma Ca2+ -Mg2+ -ATPase activity were significantly lower in elderly hypertension patients (P < 0.01). Among the three groups, plasma Ca2+ -Mg2+ -ATPase activity was significantly lower in the phlegm stasis blocking collateral group than in the Shen deficiency group (P < 0. 05). The hemorheology visualization TT (10, 30, 60, and 100 microL) was negatively correlated with DI. The hemorheology visualization TT at 100 microL was positively correlated with EAI.

CONCLUSIONChanges of hemorheology visualization TT of elderly hypertension patients were significant and correlated with traditional EAI.

Aged ; Case-Control Studies ; Erythrocyte Aggregation ; Erythrocyte Deformability ; Female ; Hemorheology ; Humans ; Hypertension ; blood ; diagnosis ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged

OBJECTIVETo observe the effects of mesenteric lymph drainage on erythrocyte rheology and blood viscosity in hemorrhagic shock rats.

METHODSWistar rats were randomly divided into sham-shock group, shock group (establishing hemorrhagic shock model), drainage group (establishing hemorrhagic shock model plus drainaging shock mesenteric lymph from hypotension 1 h). At 3 h of hypotension or corresponding time, blood samples were harvested from the abdominal aorta for determining the erythrocytic parameters, erythrocyte electrophoresis, erythrocyte sedimentation rate (ESR) and blood viscosity, and the erythrocytes aggregation index and erythrocyte deformability index were calculated.

RESULTSCompared with the sham-shock group, the red cell contents, hematocrit (HCT), hemoglobin (Hb), mean corpuscular hemoglobin concentration (MCHC), erythrocyte electrophoretic rate and mobility, erythrocyte deformability index, whole blood viscosity, whole blood relative or reduced viscosity at low and high shear rates in shock group were observably lower, and mean corpuscular volume, electrophoretic time of erythrocyte, ESR, K value of equation and K value of emendation, erythrocytes aggregation index, plasma viscosity in shock group were increased markedly; the MCHC, erythrocyte electrophoretic rate and mobility, whole blood viscosity, whole blood relative viscosity at low and high shear rates in drainage group were reduced, and the red blood cell volume distribution width -SD (RDW-SD) was increased remarkably. At the same time, in drainage group, the HCT, RDW-SD, erythrocyte deformability index, whole blood viscosity and relative viscosity at low and high shear rates were higher, the ESR, K value of equation and K value of emendation, erythrocytes aggregation index, plasma viscosity were lower than that of shock group.

CONCLUSIONThe results indicate that the mesenteric lymph drainage could improve the erythrocyte rheological behavior, as a result, improve the hemorrheological properties in hemorrhagic shock rats.

Animals ; Blood Viscosity ; Drainage ; methods ; Erythrocyte Aggregation ; Erythrocyte Deformability ; Lymph ; Male ; Mesentery ; Rats ; Rats, Wistar ; Rheology ; Shock, Hemorrhagic ; blood ; therapy

OBJECTIVETo observe the changes of blood viscosity and erythrocyte rheology in mice after acute hypoxic hypoxia (AHH).

METHODSThirty-two Kui-ming mice were randomly divided into control group, AHH group (duplicating AHH model, and divided into 5 min, 8 min, 11 min subgroups), the blood sample was taken out from heart after neck dislocation at corresponding times, for detecting the blood viscosity and erythrocyte rheology indices.

RESULTSCompared with control group, the whole blood viscosity at different shears, whole blood reduced viscosity, whole blood relative viscosity were lower and the erythrocytes aggregation index was higher in AHH 5 min group; the electrophoresis time was longer and the electrophoresis length, migration of erythrocyte were lower in AHH 8 min and AHH 11 min groups. The whole blood reduced viscosity, whole blood relative viscosity, erythrocytes aggregation index in AHH 8 min group were higher, and the erythrocyte deformability index was lower significantly than that of AHH 5 min group, respectively.

CONCLUSIONThese data suggested that the AHH could induce the blood viscosity and electrophoresis ability.

Animals ; Blood Viscosity ; Erythrocyte Aggregation ; Erythrocyte Deformability ; Erythrocyte Indices ; Erythrocytes ; physiology ; Hypoxia ; blood ; etiology ; Male ; Mice ; Mice, Inbred Strains

This study was conducted to investigate the effects of Sasa quelpaertensis bamboo and green tea on plasma and liver lipids, platelet aggregation, and erythrocyte membrane Na channels in ovariectomized (OVX) rats. Thirty female rats were OVX, and ten female rats were sham-operated at the age of 6 weeks. The rats were divided into four groups at the age of 10 weeks and fed the experiment diets: sham-control, OVX-control, OVX-bamboo leaves (10%), or OVX-green tea leaves (10%) for four weeks. Final body weight increased significantly in the OVX groups compared with that in the sham-control, whereas body weight in the OVX-green tea group decreased significantly compared with that in the OVX-control (P < 0.01). High density lipoprotein (HDL)-cholesterol level decreased in all OVX groups compared with that in the sham-control rats (P < 0.05) but without a difference in plasma total cholesterol. Plasma triglycerides in the OVX-green tea group were significantly lower than those in the sham-control or OVX-control group (P < 0.05). Liver triglycerides increased significantly in the OVX-control compared with those in the sham-control (P < 0.01) but decreased significantly in the OVX-green tea group compared with those in the OVX-control or OVX-bamboo group (P < 0.01). Platelet aggregation in both maximum and initial slope tended to be lower in all OVX rats compared with that in the sham-control rats but was not significantly different. Na-K ATPase tended to increase and Na-K cotransport tended to decrease following ovariectomy. Na-K ATPase decreased significantly in the OVX-green tea group compared with that in the OVX-control group (P < 0.01), and Na-K cotransport increased significantly in the OVX-bamboo and OVX-green tea groups compared with that in the OVX-control (P < 0.05). Femoral bone mineral density tended to be lower in OVX rats than that in the sham-control, whereas the green tea and bamboo leaves groups recovered bone density to some extent. The results show that ovariectomy caused an increase in body weight and liver triglycerides, and that green tea was effective for lowering body weight and triglycerides in OVX rats. Ovariectomy induced an increase in Na efflux via Na-K ATPase and a decrease in Na efflux via Na-K cotransport. Furthermore, consumption of green tea and bamboo leaves affected Na efflux channels, controlling electrolyte and body water balance.
Adenosine Triphosphatases ; Animals ; Blood Platelets ; Body Water ; Body Weight ; Bone Density ; Cholesterol ; Erythrocyte Membrane ; Erythrocytes ; Female ; Humans ; Lipoproteins ; Liver ; Ovariectomy ; Plasma ; Platelet Aggregation ; Rats ; Sasa ; Tea ; Triglycerides

Effects of the effective components group of Xiaoshuantongluo formula (XECG) on rat acute blood stasis model were studied under the guidance of the concept of effective components group. Rat acute blood stasis model was induced by subcutaneous injection of epinephrine combined with ice water bath. Hemorheology indices such as whole blood viscosity, plasma viscosity, erythrocyte aggregation index and platelet aggregation rate; coagulation parameters including PT, APTT, TT and FIB; 6-keto-PGF1alpha, TXB2 and D-dimer levels were determined to evaluate the effects of XECG. The results showed that XECG significantly reduced ADP-induced platelet aggregation, but showed little influence on the whole blood viscosity, plasma viscosity and erythrocyte aggregation rate. XECG extended PT and TT slightly, but had no effects on APTT and FIB content. D-dimer levels significantly decreased after administration of XECG with a little decrease of TXB2, but the content of 6-keto-PGF1alpha did not change significantly. The results suggest that the role of XECG of anti-aggregation is more prominent.
6-Ketoprostaglandin F1 alpha ; blood ; Animals ; Blood Coagulation ; drug effects ; Blood Coagulation Disorders ; blood ; Blood Viscosity ; drug effects ; Drug Combinations ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Erythrocyte Aggregation ; drug effects ; Fibrin Fibrinogen Degradation Products ; metabolism ; Hemorheology ; drug effects ; Male ; Partial Thromboplastin Time ; Plants, Medicinal ; chemistry ; Platelet Aggregation ; drug effects ; Prothrombin Time ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Thrombin Time ; Thromboxane B2 ; blood

AIMTo establish reference range of blood theology for different gender by sitting and lying in healthy populations.

METHODSIn 31 volunteers blood were drawed in the postures of sitting and lying to measure blood rheology. Data (between July 2002 and July 2006) of 32854 samples (23436 check-up, 6553 out-patient,2865 in-patient) were collected. Differences between different postures and different gender were compared by Independ-Sample t-test with SPSS 13.0 software and each reference range of blood rheology was established.

RESULTSIn sitting and lying postures 12 parameters of blood rheology showed great significance (P < 0.01). 8 parameters such as whole blood viscosity, blood reduce viscosity, plasma viscosity, hematocrit, were decreased by 9.33% on average while posture was changed from sitting to lying. But index of erythrocyte deformability, erythrocyte electrophoresis presented inverse correlation and were increased by 6.49% on average with the same posture change.Various parameters of blood theology in different gender showed great significance (P < 0.01).

CONCLUSIONThere is significant difference in various parameters of blood rheology in the posture change from sitting to lying. Reference ranges of blood theology of different postures are established which may be used to decrease the rate of misdiagnosis by 8-10 percent.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Blood Viscosity ; Child ; China ; Erythrocyte Aggregation ; Erythrocyte Deformability ; Female ; Hemorheology ; Humans ; Male ; Middle Aged ; Posture ; physiology ; Reference Values ; Young Adult