1.Perioperative blood management of a patient with coagulation factor Ⅴ deficiency and literature review
Ronghui SHI ; Qiang MENG ; Jianjun WU ; Lan YANG ; Xiaoqiong LONG ; Li ZHANG ; Shuming ZHAO
Chinese Journal of Blood Transfusion 2023;36(11):1057-1060
【Objective】 To explore the perioperative blood management in patients with pancreatic pseudocyst combiend with coagulation factor Ⅴ(FⅤ) deficiency. 【Methods】 Preoperative: In order to determine the effect of cryoprecipitated antihemophilic factor and fresh frozen plasma (FFP) on the elevation level of factor Ⅴ, we alternately infused cryoprecipitate and FFP in the resting state. TEG, coagulation function and coagulation factor activity were monitored before and 1 h, 24 h and 48 h after infusion, and intraoperative and postoperative blood transfusion strategies were formulated. FFP 600 mL and cryoprecipitate 10 U were supplemented preoperatively. Intraoperative: The operation procedure was performed for 7 hours with an infusion of 600 mL FFP without significant bleeding. Postoperative: FFP was infused. 【Results】 Preoperative: The coagulation factor Ⅴ activity on pre-operation was 1.9% and 1.8%. After alternating infusion cryoprecipitate 10 U and FFP 1 200 mL, the FⅤactivity increased to 5.1% and 6.0%, respectively. There was no significant difference in TEG parameters, PT and ATPP results were decreased to varying degrees. Intraoperative: The operation was successful without obvious bleeding. Postoperative: FFP 500 mL was infused 2 h after operation, and FFP 250-500 mL was injected daily from 1 to 7 days after surgery. No significant bleeding was observed in the wound, the results of TEG, PT, APTT and hemoglobin (Hb) did not change significantly compared with those before surgery. The patient was discharged successfully 12 days after surgery. The genetic test results showed that he had inherited coagulation factor Ⅴ deficiency, which was a compound heterozygous variation. 【Conclusion】 Perioperative blood management in patients with FⅤ deficiency combined with surgical disease, requiring pre-transfusion evaluation and post-transfusion evaluation in combination with laboratory investigations and clinical manifestations, cryoprecipitate and fresh frozen plasma can be effective in supplementing coagulation factors. The TEG seems to be better than the Seven items of coagulation function in judging the clotting status of patients with FⅤ deficiency.
2.Application of allogeneic platelet gel in surgical operation for giant aortic aneurysms, one case
Jianjun WU ; Bin JIANG ; Renxue XIANG ; Ronghui SHI ; Kang YANG ; Wei LIU ; Xin CUI ; Shuming ZHAO
Chinese Journal of Blood Transfusion 2021;34(7):698-701
【Objective】 To explore the effect of allogeneic platelet gel on hemostasis and repair of vascular anastomoses and wounds in patients with giant aortic aneurysms during surgery. 【Methods】 One adult dose of allogeneic platelets, applied as platelet rich plasma (PRP), was prepared as platelet gel (PG) (about 220 mL) for spraying or smearing at the vascular anastomosis and thoracic wound during the surgery of giant aortic aneurysms. 【Results】 The gel formation was presented about 30 seconds after spraying or smearing with PG on the anastomotic and wound surface. The hemostatic effect is good, with less postoperative drainage fluid from pericardium and mediastinum than usual, and the ICU stay was 4 days. 【Conclusion】 Allogeneic platelets as a source of PRP to prepare PG may be applied to obtain the clotting and healing during surgical operation.
3.Centrifugal plasma separation combined with plasma adsorption in the treatment of hypertriglyceridemia: A clinical observation of 42 cases
Yan BAI ; Jianjun WU ; Jingfang YANG ; Shuming ZHAO
Chinese Journal of Blood Transfusion 2021;34(7):691-694
【Objective】 To investigate the clinical efficacy and safety of centrifugal plasma separation combined with plasma adsorption in the treatment of hypertriglyceridemia. 【Methods】 The data of 42 patients with hypertriglyceridemia from February 2019 to October 2020 were retrospectively collected and analyzed. The patients were treated with plasma component exchange by centrifugal plasma separation combined with plasma adsorption (PA) lipid-lowering therapy. The plasma was separated by an automatic blood cell separator, and was then adsorbed by membrane plasma component absorber. Conditions for plasma component exchange were sodium citrate as anticoagulant, the whole blood flow rate at (30~80) mL/min, the plasma circulation volume 2 500 mL, the treatment time 2 h, and the discarded plasma 200 mL. The treatment was performed once every two weeks, twice in total, and the efficacy was evaluated 6 weeks later. The changes of serum total protein (TP), blood lipid indexes and hemorheology indexes before and after treatment were observed, and the adverse reactions during treatment were recorded. 【Results】 The effective rate of 42 patients after treatment was 95.24%. The values of TP, TC, TG and LDL-C decreased significantly (82.53±6.37 vs 74.26±5.91, 7.46±1.83 vs 3.88±1.06, 5.91±2.16 vs 2.20±1.13, 4.23±1.02 vs 3.17±0.85) while HDL-C increased significantly(0.92±0.15 vs 1.23±0.26) after the treatment (P<0.05). After the treatment, the levels of whole blood high-cut viscosity, whole blood low-cut viscosity, plasma viscosity, hematocrit and fibrinogen decreased significantly (7.53±1.21 vs 5.16±0.88, 18.27±3.15 vs 12.04±2.32, 2.46±0.37 vs 1.68±0.29, 52.24±5.31 vs 32.53±4.42, 4.28±0.76 vs 3.14±0.45)(P<0.05). The incidence of adverse reactions was 14.3%, and no serious adverse reactions were observed. 【Conclusion】 The centrifugal plasma separation combined with plasma adsorption in the treatment of hypertriglyceridemia is safe and effective.
4.Efficacy of autologous ozoneized blood transfusion in improving motor function in convalescent stroke patients
Yang CHEN ; Qunqiang WU ; Ying LI ; Xiaoqing WANG ; Shijie MU ; Shuming ZHAO
Chinese Journal of Blood Transfusion 2023;36(2):105-108
【Objective】 To investigate the efficacy of autologous ozoneized blood transfusion(AOBT) in improving consciousness and motor function in convalescent stroke patients. 【Methods】 A total of 44 patients who were diagnosed as convalescent cerebral apoplexy and received treatment in Rehabilitation Department of our hospital from August 2016 to September 2021 were randomly divided into the experimental group and control group by blind method. The experimental group (n=22) received general rehabilitation training (such as exercises, occupational therapy, acupuncture and transcranial magnetic stimulation) plus AOBT (200 mL venous phlebotomy at the median elbow), once every 2 to 3 days and 12 occasions as a course of treatment; the control group solely recieved general rehabilitation training. The consciousness (GCS score) and ability of daily living (Barthel index score) score of the two groups before and after treatment were statistically compared, and Ueda motor function grade, Brunnstrom stage and muscle tone grade were observed and evaluated. 【Results】 After the treatment, the experimental group and the control were compared as follows: 1) the GCS score and Barthel score was 14.82±0.39 vs 12.41±2.52, 61.14±12.24 vs 52.05±11.72(P<0.05); 2) The recovery rate of motor function was 95.45% (21/22) vs 63.64% (14/22) (P<0.05); 3) The total recovery rate of muscle tone was 90.91% (20/22) vs 63.64% (14/22) (P<0.05). 【Conclusion】 AOBT, with somewhat high safety and effectiveness, can improve the state of consciousness, motor function and muscle tone in convalescent patients with stroke.
5.Exploration on the effects and value of new cognitive dimension of EQ- 5D-5L in rural population of Guizhou
Yan HUANG ; Hongyan WU ; Zhihao YANG ; Nan LUO ; Long WANG ; Xiao LIN ; Xingmin HAO
China Pharmacy 2022;33(2):203-208
OBJECTIVE To provide re ference for accurate measurem ent of population health status ,pharmacoeconomic evaluation and guidance of health resource allocation. METHODS Using quota and convenient sampling ,five administrative villages were selected from the rural areas under the jurisdiction of Liuzhi special zone ,Qianxi city and Jianhe county of Guizhou province from July to September 2020. Based on the gender and age ratio quota of rural population in the results of the national census,330 respondents were selected for questionnaire survey. The contents of the questionnaire included the self-made scale containing sociodemographic characteristics and general health information ,five-level EuroQoL five-dimension questionnaire (EQ-5D-5L,hereinafter referred to as the “new dimension scale ”)with cognitive dimensions (including attention ,memory, computing ability and learning ability )and mini-mental state examination (MMSE). The effects of reliability ,validity and new dimensions of new dimension scale on respond ents’quality of life were investigate ,and its measurement characteristics were verified;the application value of it in pharmacoeconomic hy_cheer@126.com evaluation and guiding the allocation of health resources were explored. RESULTS A total of 330 questionnaires weredistributed,320 were recovered and 320 were effective. The recovery rate and effective rate were 96.97% and 100% respectively. The ceiling effect of new dimension scale was 13.44%,the split-half reliability was 0.821,and the overall Cronbach ’s α was 0.852. Exploratory factor analysis showed that the new dimension scale was loaded with physiological ,cognitive and psychological factors ,and the cumulative contribution rate was 69.35%. The correlation coefficient between the new dimension and the dimension of MMSE scale were 0.19-0.61,showing a moderate or medium to strong correlation (P<0.01). Compared with EQ- 5D-5L,after adding each dimension ,the interpretation ability of the regression model was improved by 5.00%-17.50%. CONCLUSIONS The new dimension scale has high feasibility ,good reliability and validity ,significantly reduces the ceiling effect of EQ- 5D-5L,has higher sensitivity to the evaluation of people ’s quality of life,and can better evaluate the quality of life of rural population. It is suggested that it can be applied for quality of life evaluation,intervention effect analysis and related economic evaluation.
6.Preliminary exploration on operation process for autologous ozonized blood transfusion
Jianjun WU ; Yan BAI ; Yanli BAI ; Zhanshan ZHA ; Jing CHEN ; Yahan FAN ; Jiwu GONG ; Shouyong HUN ; Hongbing LI ; Zhongjun LI ; Jiajin LIN ; Chunxia LIU ; Fenghua LIU ; Jiubo LIU ; Jingling LUO ; Xianjun MA ; Deying MENG ; Shijie MU ; Mei QIN ; Hui WANG ; Haiyan WANG ; Qiushi WANG ; Quanli WANG ; Xiaoning WANG ; Yongjun WANG ; Changsong WU ; Lin WU ; Jue XIE ; Pu XU ; Liying XU ; Mingchia YANG ; Yongtao YANG ; Yang YU ; Zebo YU ; Juan ZHANG ; Xiaoyu ZHOU ; Xuelian ZHOU ; Shuming ZHAO
Chinese Journal of Blood Transfusion 2023;36(2):95-100
Autologous ozonized blood transfusion(AOBT) is a therapy of re-transfusion of 100-200 mL of autologous blood after shaking and agitation with appropriate amount of oxygen-ozone in vitro. The oxidation of blood through the strong oxidation of ozone can enhance the non-specific immune response of the body, regulate the internal environment and promote health. This therapy has been increasingly applied in clinical practice, while no unified standard for the operation process in terms of ozone concentration, treatment frequency and treatment course had been established. This operation process of AOBT is primarily explored in order to standardize the operation process and ensure its safety and efficacy.
7.Preparation,characterization and gastric mucosal permeability of evodiamine phospholipid complex self- microemulsifying drug delivery system
Shuoyao SONG ; Guiqian YANG ; Ling TAO ; Xiangchun SHEN ; Huan ZHANG ; Herong LI ; Shouli WANG ; Huiyun SHI ; Wen LIU
China Pharmacy 2022;33(9):1056-1062
OBJE CTIVE To prepare and characterize evodiamine phospholipid complex self-microemulsifying drug delivery system(EVO-PC-SMEDDS),and to investigate its gastric mucosal permeability. METHODS EVO-PC-SMEDDS was prepared , and particle size ,polydispersity(PDI)and Zeta potential were tested ,and microscopic observation was carried out. The stability of EVO-PC-SMEDDS in simulated gastric liquid with different pH (1.2,2.0,4.0,7.0)was investigated. The entrapment efficiency and drug-loading amount of the preparation were determined ,and the in vitro release was investigated. The gastric mucosal permeability of EVO-PC-SMEDDS was studied by combining rat gastric mucosal tissue and Ussing Chamber technology. RESULTS The particle size of EVO-PC-SMEDDS was (53.63±1.51)nm,PDI and Zeta potential were 0.217±0.017 and (-12.20±0.15)mV,entrapment efficiency was (95.25±0.97)% and drug-loading amount was (19.30±1.21)mg/g. EVO-PC- SMEDDS exhibited a uniformly dispersed round spherical shape under transmission electron microscope. Stability experiments showed that EVO-PC-SMEDDS exhibited no significant change in particle size ,PDI and Zeta potential under the simulated gastric fluid with different pH and showed excellent stability. Results of in vitro release test showed that compared with evodiamine (EVO),in vitro accumulative release of EVO-PC-SMEDDS were enhanced 6.83-fold,which was in line with the first-order kinetic release model. Results of gastric mucosal permeability showed that gastric mucosal permeation transport ,permeation rate , permeation flux and area under curve of cumulative permeability of EVO-PC-SMEDDS were higher than those of EVO , respectively. CONCLUSIONS EVO-PC-SMEDDS is prepared N successfully and shows good stability. It could significantly improve the release behavior and gastric mucosal permeability of EVO.
8.Formulation Optimization of Zuojin Pectin Capsule and Its Protective Effect on Gastric Ulcer Model Rats
Guiqian YANG ; Wen LIU ; Ling TAO ; Xiangchun SHEN ; Shuoyao SONG ; Huan ZHANG ; Herong LI ; Shouli WANG ; Huiyun SHI
China Pharmacy 2021;32(19):2327-2335
OBJECTIVE:To optimize the form ulation of Zuojin pectin c apsules,and to prepare modern Zuojin pectin capsules with protective effects against gastric ulcers. METHODS :The formulation of Zuojin pectin capsules was optimized with orthogonal test with the contents of pectin ,soluble starch and dextrin as factors ,using formability ,moisture absorption and flow ability as indicators. Zuojin pectin capsule was prepared by wet granulation filling method with Zuojin extract powder as raw material. The contents of palmatine hydrochloride ,berberine hydrochloride ,evodiamine and rutaecarpin were evaluated by HPLC. Basket method was used to investigate the release behavior of the capsule in 0.1 mol/L HCl solution. The gastric ulcer model of rats was established by intragastric administration of 75% ethanol. Gastric ulcer index ,the inhibition rate of gastric ulcer and the pathological sections were used as indexes to investigate the protective effect of Zuojin pectin capsules (the doses were 54,108, 216 mg/kg)on gastric ulcer. RESULTS :The optimal formulation of Zuojin pectin capsules included 45% pectin,12% soluble starch,27% dextrin and 1% xylitol. Results of in vitro drug , release showed that palmatine hydrochloride and berberine, hydrochloride in Zuojin pectin capsules released 53.76% and No.54.82% respectively within 1 h,completely released at about 8 h, and conformed to the zero-order release behavior. 2492109374@qq.com Different doses of Zuojin pectin capsule could improve the ulcer injury of gastric tissue in gastric ulcer model rats to different extent ,and significantly reduced the gastric ulcer index(P<0.01),significantly increased the inhibition rate of gastric ulcer and the percentage of positive expression area of Schiff ’s iodate staining (P<0.01). CONCLUSIONS :Zuojin pectin capsule with protective effect on gastric ulcer and certain sustained- release effect is successfully prepared.