OBJECTIVE: To explore the related risk facts of pulmonary thromboembolism (PTE) and analyze the relation between PTE and the trauma or medical behavior by investigating the cases of PTE. METHODS: Thirty-three cases were selected from Institute of Forensic Science (IFS) from 2000 to 2014. RESULTS: In 33 cases, 16 decedents were male, 17 decedents were female; different degrees of dyspnea, chest tight- ness and syncope symptoms were the clinical manifestation of the deceased; the thrombus was mainly distributed in the left and right pulmonary arteries. The main source of embolism was the deep vein of lower limb and the left probability was higher. Trauma, limited position, operation and cardiovascular disease showed high-risk factors of PTE; D-Dimer test, hemolytic test and computer tomography pul- monary angiography were the diagnostic tools for PTE. In some cases, trauma and medical malpractice could be involved in the cause of death. CONCLUSION Non-typical clinical symptoms present in the most cases caused by PTE, and these cases always show many high-risk factors. The relation between PTE and injury or medical behavior should be considered carefully in the forensic pathological practice.
Female ; Fibrin Fibrinogen Degradation Products/chemistry* ; Forensic Pathology ; Humans ; Lower Extremity/pathology* ; Lung/pathology* ; Male ; Malpractice ; Pulmonary Embolism/mortality*

The Modified silk fibroin membranes were prepared by mixing the aqueous solutions of both silk fibroin and chitosan with the use of oxidized glucose aldehyde as a crosslinking agent. It was characterized by FTIR, DSC, measurements of membrane-potential and mechanical properties, the water swelling ratios and permeability coefficient for model drug 5-Fu in the different pH buffer solutions. It was shown that there were some strong hydrogen bond interaction and good compatibility between silk fibroin and chitosan molecules in the modified silk fibroin films. The isoelectric point of modified fibroin film was about pH 5.35, but that of natural fibroin film was around pH 4.5. It was also found that the mechanical properties of modified fibroin films were much better than those of fibroin itself. Its tensile strength and breaking elongation were greatly enhanced with the increase of chitosan content and their maximum values were as high as 71.4-72.7 MPa and 2.96%-3.82% respectively, at the composition of 40 wt%-60 wt% chitosan. Its coefficient of permeability decreased firstly and then increased slowly with the change of the pH value of solutions from pH 5 to pH 9, and the minimum coefficient of permeability was observed when pH=7.
Biocompatible Materials ; chemistry ; Chitosan ; chemistry ; Cross-Linking Reagents ; Delayed-Action Preparations ; Drug Carriers ; chemical synthesis ; Fibrin Fibrinogen Degradation Products ; Fibroins ; chemistry ; Hydrogen-Ion Concentration ; Membranes ; Silk ; chemistry

OBJECTIVETo explore the effect of plasma cross-linked D-dimer (XDP) and neuron-specific enolase (NSE) on the infarct volume and neurological function deficit in patients with cerebral infarction (CI).

METHODSPlasma XDP and NSE levels were measured in 66 CI patients on the different days after onset and also in 46 normal individuals, and the changes in XDP and NSE levels were analyzed in the CI patients with different infarct volume and neurological function deficit scores.

RESULTSWithin 48 h following CI onset, plasma XDP and NSE levels increased significantly (P<0.01) and reached the highest levels on day 5 (P<0.001), recovering the normal level till day 18. Plasma XDP and NSE levels were significantly higher in patients with moderate to large infarct volume and in those with moderate to severe neurological deficits than in those with small infarct volume and mild neurological deficits (P<0.001).

CONCLUSIONIncrement of XDP and NSE levels is an important pathological process in CI in close relation to the infarct volume and neurological deficits. XDP and NSE may serve as reliable indices for early diagnosis and evaluation of CI.

Aged ; Biomarkers ; Cerebral Infarction ; blood ; pathology ; Cross-Linking Reagents ; chemistry ; Female ; Fibrin Fibrinogen Degradation Products ; chemistry ; metabolism ; Humans ; Male ; Middle Aged ; Phosphopyruvate Hydratase ; blood

This study was aimed to investigate the correlation of coagulation indicators [prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) and fibrinogen (FIB), antithrombinIII (ATIII), D-dimer (D-D) levels] with inflammatory markers [procalcitonin (PCT), C reactive protein (CRP), interleukin-6 (IL-6), serum amyloid A (SAA)] for sepsis in hematologic malignancy patients. A total of 326 febrile in patients with hematologic diseases from 2062 patients in West China Hospital, Sichuan University from March 2011 to April 2013 were retrospectively analyzed. The patients were divided into sepsis group(n = 72), non-sepsis group(n = 176) and non-sepsis with low Alb group (n = 78) according to blood culture. The results showed that the values of PT, APTT, D-dimer, Plt in sepsis group were higher than those in non-sepsis group, and the difference between them was statistically significant. While the ATIII level in the sepsis group was lower than that in non-sepsis group, and the difference between them was statistically significant (P < 0.05). And the four inflammatory biomarkers in the sepsis patients were higher than those in non-sepsis patients (P < 0.05). TT and FIB level were not significantly different (P > 0.05). There was not a significant difference in these indicators between non-sepsis group and non-sepsis with low Alb group. The correlation analysis suggested that the level of PCT positively correlated with APTT, D-dimer level (P < 0.05); and negatively correlated with the ATIII (P < 0.05). It is concluded that sepsis results in the concurrent activation of inflammatory and procoagulant pathways. The hematologic malignancy patients with sepsis have an obviously higher systemic inflammatory response, and accompanied with coagulation dysfunction.
Biomarkers ; Blood Coagulation ; C-Reactive Protein ; Calcitonin ; Calcitonin Gene-Related Peptide ; Fibrin Fibrinogen Degradation Products ; Hematologic Neoplasms ; chemistry ; complications ; Humans ; Interleukin-6 ; Partial Thromboplastin Time ; Protein Precursors ; Retrospective Studies ; Sepsis ; complications ; Serum Amyloid A Protein ; Thrombin Time

OBJECTIVETo evaluate the effect of decoction for invigorating the kidney and improving blood circulation to thrombosis and pathology on rabbit blood stasis model.

METHODThirty rabbits were ramdomly divided into normal group, model group, high dose group, low dose group and Xue Shuan Ning group. Tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor (PAI), fibrinogen (Fbg) and D-dimer (DD) were investigated after those rabbits had been treated. One rot was solected randomly from each group to observe pathological changes.

RESULTThere were significant differences in t-PA, PAI, Fbg and DD between normal group and other groups is very obvious (P < 0.01) . Between groups of high dose low dose Xue Shuan Ning and model, the statistical differeces were significant, as well as between groups of high dose, low dose and Xue Shuan Ning groups (P < 0.05). However, there was no statistical difference between high dose group and high dose group (P > 0.05). The pathological changes in model group were most serious, those in Xue Shuan Ning were less serious. There were slight pathological changes in high dose group and low dose group.

CONCLUSIONModels ware made successfully. High dose group and low dose group have stronger effect on thrombosis than Xue Shuan Ning group.

Animals ; Blood Viscosity ; drug effects ; Dose-Response Relationship, Drug ; Drug Combinations ; Drugs, Chinese Herbal ; administration & dosage ; isolation & purification ; pharmacology ; Female ; Fibrin Fibrinogen Degradation Products ; metabolism ; Fibrinogen ; metabolism ; Hematocrit ; Male ; Plants, Medicinal ; chemistry ; Plasminogen Inactivators ; blood ; Rabbits ; Random Allocation ; Thrombosis ; blood ; pathology ; Tissue Plasminogen Activator ; blood

OBJECTIVETo evaluate the effect of decoction for invigorating the kidney and improving blood circulation to thrombosis on rabbits blood stasis model.

METHODThirty rabbits were randomly divided into normal group, model group, heavy dose group, slight dose group and xue shuan ning group. Tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor (PAI), fibrinogen (Fbg) and D-dimer (DD) were investigated after those rabbits had been treated. One was selected randomly from each group to observe pathological changes.

RESULTThere was significant difference in t-PA, PAI, Fbg and DD between normal group and other groups (P < 0.01). Among groups of heavy dose, slight dose, xue shuan ning and model, the statistical differences were significant, as well as among groups of heavy dose, slight dose and xue shuan ning (P < 0.05). However, there was no statistical difference between heavy dose group and slight dose group (P > 0.05). The pathological changes in model group were most serious, and those in xue shuan ning were less serious. There were slight pathological change in heavy dose group and light dose group.

CONCLUSIONModels were made successfully. Heavy dose group and slight dose group have stronger effect on thrombosis than xue shuan ning group.

Animals ; Dose-Response Relationship, Drug ; Drug Combinations ; Drugs, Chinese Herbal ; administration & dosage ; isolation & purification ; pharmacology ; Female ; Fibrin Fibrinogen Degradation Products ; metabolism ; Fibrinogen ; metabolism ; Kidney ; pathology ; Liver ; pathology ; Lung ; pathology ; Male ; Medicine, Chinese Traditional ; Plants, Medicinal ; chemistry ; Plasminogen Inactivators ; blood ; Rabbits ; Random Allocation ; Thrombosis ; blood ; pathology ; Tissue Plasminogen Activator ; blood

To investigate the effects of complex danshen solution and heparin on the changes of blood coagulation factors in rats with hemorrhagic shock, and to explore the therapy of coagulopathy by compound danshen solution, the rat model of hemorrhagic shock was set up, 40 SD rats were randomized into four groups: sham operation, shock, compound danshen solution and heparin groups, each group was composed of 10 SD rats. Plasma SFMC, TM, ATIII, D-D, t-PA, PAI levels and APTT were detected, incidences of bleeding complications between heparin and danshen group were compared. The results showed that plasma SFMC, D-D levels in shock group were higher but ATIII level in shock group was lower than that in sham operation group, compound danshen solution group and heparin group (P < 0.001), TM levels obviously increased in shock group and heparin group (P < 0.001). There was no significant difference between compound danshen solution and sham-operation groups. Plasma t-PA, D-D levels obviously increased after shock for 2 hours, PAI level reached the peak after shock for 4 hours, but t-PA decreased. After shock for 6 hours, plasma PAI descended, t-PA continually drop in, but PAI and D-D remained in higher levels. Plasma D-D level in heparin group was lower than that in shock group, t-PA level was higher than that in shock group, but there was no significant difference between in heparin and shock groups. Plasma t-PA, PAI and D-D levels in compound danshen solution group were lower than that in shock group. APTT of danshen group was lower than that of shock group and heparin group. Bleeding incidences was 30% in heparin group and 0% in danshen group, respectively. It is concluded that compound danshen solution may used to treat hypercoagulation and hyperfibrinolysis. In comparsion with heparin, danshen posses-ses advantages of safety with less bleeding complication and needs not tight monitor.
Animals ; Anticoagulants ; therapeutic use ; Blood Coagulation ; drug effects ; Blood Coagulation Factors ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Fibrin Fibrinogen Degradation Products ; metabolism ; Heparin ; therapeutic use ; Male ; Partial Thromboplastin Time ; Phytotherapy ; Plasminogen Activator Inhibitor 1 ; blood ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Salvia miltiorrhiza ; chemistry ; Shock, Hemorrhagic ; blood ; drug therapy ; Thromboplastin ; metabolism ; Tissue Plasminogen Activator ; blood

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

OBJECTIVETo investigate the pathogenesis of thromboembolism in patients with mitral stenosis in a pre-thrombotic state.

METHODSThe biochemical markers' levels in plasma for platelet activity [soluble P-selectin (GMP-140)], states of thrombin generation [antithrombin III (AT III) and protein C (PC)], fibrinolysis [D-dimer (DD), plasminogen activator inhibitor 1 (PAI-1), tissue plasminogen activator (t-PA) and FDP] and von Willebrand factor (vWF) were determined from blood specimens obtained from the femoral veins and arteries and the right and left atria of 43 consecutive patients (20 with atrial fibrillation and 23 with sinus rhythm) with mitral stenosis (MS), undergoing percutaneous mitral valvuloplasty. The same parameters were compared with those of 15 control subjects, who had no detectable heart disease, but with paroxysmal supraventricular tachycardia undergoing radiofrequency catheter ablation of the left accessory pathway through a transseptal passage.

RESULTSBlood from the left atrium contained an excessive amount of platelet activity, thrombin generation and fibrinolysis compared with the blood from the right atrium, and the femoral veins and arteries. However blood from the right atrium was much lower in these activities when compared with those from the left atrium, and the femoral veins and arteries in both groups. Compared with those in the control subjects, GMP-140 in the left atrium was significantly higher (P < 0.05) and AT III was significantly lower (P < 0.05) in patients with MS. Compared with the patients with MS and spontaneous left atrial echocontrast (LASEC) /= 2 had significantly higher levels of GMP-140 in plasma (P < 0.05), and significantly lower levels of AT III (P < 0.05) and PC (P < 0.01) levels in the left atrium. However, there were no significant differences between patients with atrial fibrillation and those with sinus rhythm regarding amounts of plasma coagulation markers in the left atrium. Univariate regression analysis revealed that LASEC was negatively correlated with plasma levels of blood from the left atria in the patients with MS.

CONCLUSIONCoagulability is increased in the left atria of patients with MS and is positively correlated with LASEC.

Adult ; Antithrombin III ; analysis ; Female ; Fibrin Fibrinogen Degradation Products ; analysis ; Heart Atria ; chemistry ; Humans ; Male ; Mitral Valve Stenosis ; complications ; P-Selectin ; blood ; Plasminogen Activator Inhibitor 1 ; blood ; Protein C ; analysis ; Regression Analysis ; Thromboembolism ; etiology ; Thrombophilia ; blood ; complications ; von Willebrand Factor ; analysis

OBJECTIVETo investigate the effect of Shengmai Injection (SMI) on blood coagulation in patients with chronic heart failure (CHF).

METHODSSixty patients with CHF were randomly divided into two groups, the 30 patients in the treated group were treated with SMI plus conventional treatment of western medicine, and the 30 in the control group treated with conventional treatment alone. The changes of cardiac function were observed and levels of plasma P-selectin, von Willebrand's factor (vWF) and D-dimer were determined.

RESULTSThe total effective rate and the markedly effective rate in the treated group were higher than those in the control group respectively. The levels of P-selectin, vWF and D-dimer lowered in both groups significantly after treatment, but the effect of lowering was better in the treated group than that in the control group.

CONCLUSIONHypercoagulative state exist in patients with chronic heart failure. SMI could improve the state in patients, which may reduce the occurrence and developing of emboic events to certain extent.

Aged ; Aged, 80 and over ; Blood Coagulation ; drug effects ; Drug Combinations ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Female ; Fibrin Fibrinogen Degradation Products ; metabolism ; Heart Failure ; blood ; drug therapy ; Humans ; Infusions, Intravenous ; Male ; Middle Aged ; P-Selectin ; blood ; Panax ; chemistry ; Phytotherapy ; von Willebrand Factor ; metabolism