BACKGROUND: Microsurgical operation might fail due to trauma-induced hypercoagulability.OBJECTIVE: To observe the changes of polymerization of fibrin monomer after the treatment of trauma so as to explore an effective means for assisting the prediction of post-traumatic hypercoagulability and thrombosis.DESIGN: Case-control observation and self-control study.SETTING: Institute of Thrombus and Hemostasis, the Union Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology.PARTICIPANTS: Totally 34 traumatic patients were included from those who were admitted to the Union Hospital affiliated to Tongji Medical College, Huazhong University of Science and Technology, between May 2001 and January 2002. There were 18 males and 16 females aged 8-65 years old. Another 96 healthy people, 50 males and 46 females aged 21-68 years old, who came for routine physical examination were enrolled as normal controls. The history of coagulation impairment, and general and coagulation-related diseases were excluded in all the subjects.METHODS: Polymerization of plasmic fibrin monomer was detected. Fibrinogen would transform into fibrin monomers and display polymerization induced by acutobin. The accompanied changes of the turbidity were dynamically monitored using spectrophotometer at 340 nm; the obtained electrical signals were then input into the computer for statistical analysis. Venous blood samples were collected from traumatic patients immediately after hospitalization and on the 3rd day after the treatment with clinical debridement, surgery, sutures, liquid supplement and administration of antibiotics to determine polymerization of fibrin monomer. MAIN OUTCOME MEASURES: ① The rate of polymerization of fibrin monomer (taken as the comprehensive predictor for the concentration and function of plasmic fibrinogens). ② Maximum absorbency (reflecting the amount of coagulable plasmic fibrinogen in blood specimen). ③ The ratio between the rate of polymerization of fibrin monomer and maximum ab sorbency (reflecting the polymerization of plasmic fibrinogen molecules). RESULTS: All participants completed the corresponding examinations and were brought into data analysis. ① In traumatic group, the rate of fibrin monomer polymerization, the content of fibrinogen, the ratio of polymerization rate to maximum absorbency were all significantly higher than those in normal control group [traumatic group: 0.87±0.31, (5.81±3.22) g/L,4.61±0.97; normal control group: 0.61±0.15, (3.36±1.02) g/L, 3.93±0.68,P ＜ 0.01]. ② At treatment of 3 days, although the rate of polymerization and the content of fibrinogen were found slightly declined, they were still higher than those in normal group [3.93±0.68, (4.21±1.93) g/L]; however,the ratio of polymerization rate to maximum absorbency did not change after treatment (4.68± 1.19).CONCLUSION: The content and function of fibrinogen would increase in traumatic patients. Traumatic patients display hypercoagulability characteristics and have thrombosis tendency. Determining the polymerization of fibrin monomer can be taken as an effective means for assisting the prediction of posttraumatic hypercoagulability and thrombosis.

BACKGROUND: The elevation of plasma fibrinogen(Fbg) is a key risk factor of cerebrovascular diseases. The evaluation of the monomer polymerization function of fibrin has even more important clinical merit than the detection of Fbg level.OBJECTIVE: To investigate the clinical significance of the monomer polymerization function of fibrin in patients with isehemie cerebrovascular diseases and its impacts on rehabilitative intervention.DESIGN: A case control study employing patients and healthy individual as subjects.SETTING: An Institute of Hematology and Department of Neurology of one university.PARTICIPANTS: Totally 110 patients with different ischemic cerebrovascular disease selected from the Department of Neurology, Union Hospital of Tongji Medical College, Huazhong Science and Technology University from September 2001 to March 2002, and 50 healthy individuals were included in the study.METHODS: Rehabilitative intervention was performed in 31 randomly selected cerebral infarct patients, and the parameters indicating the monomer polymerization functions of fibrin in the plasma were detected by the measurement system for the monomer polymerization function of fibrin.MAIN OUTCOME MEASURES: Abnormal condition of monomer polymerization function of fibrin in each parameter.RESULTS: Each parameter indicating the monomer polymerization functions of fibrin in plasma was significantly increased in ischemic cerebrovascular diseases patients than healthy individuals( P ＜ 0.01 ) . The abnormal rate of Fbg leveland fibrin monomer polymerization velocity (FMPV) was significantly elevated in ischemic cerebrovascular disease patients than healthy individuals ( P ＜ 0. 01 ) . The relative risk(RR) of ischemic cerebrovascular diseases in patients with abnormal FMP functions was 4 to 31 times more than healthy control group. In cerebral infarct group, FMPV of anterior circulation infarct subgroup was significantly elevated than that of posterior circulation infarct and lacunar cerebral infarct subgroups( P ＜ 0.05). The FMP function of anterior cerebral infarct patients was significantly higher than that of healthy group before rehabilitative intervention. Although each FMP parameter reduced after rehabilitative intervention, the difference between was not significant compared with that of before therapy.CONCLUSION: FMP function analysis can completely and objectively reflect the coagulation status of the patients with ischemic cerebrovascular diseases, and it can also reflect the range and severity of infarct to some extent. Although common rehabilitative intervention cannot effectively improve the high-coagulation of the blood, the impacts of specific rehabilitative intervention on the coagulation mechanism deserve further investigation.

The plasma levels of inflammatory cytokine interleukin-6 (IL-6) and anti-inflammatory cytokine interleukin-10 (IL-10) in the patients with unstable angina or stable angina were determined and compared. In 30 patients with unstable angina and 22 patients with stable angina, plasma levels of IL-10 and IL-6 were detected by ELISA and plasma lipid parameters by lipid research clinical methods respectively. The results showed plasma levels of IL-10 were significantly lower in unstable angina group than in stable angina group (P = 0.005), while those of IL-6 were significantly increased in unstable angina group as compared with those in stable angina group (P = 0.039). There was a significantly negative correlation between IL-10 and IL-6 in patients with unstable angina (r = -0.41, P = 0.003). In the unstable angina group, IL-6 levels were obviously positively correlated with TC (r = 0.314, P = 0.023), but not with TG and HDL. There were no significant correlations between IL-10 and plasma lipid parameters. It was suggested that the decreased IL-10 and increased IL-6 might be associated with the atheromatous plaque stability and progression of coronary heart diseases. IL-10 may play an important role in preventing coronary vascular lesions.
Angina, Unstable/*blood ; Interleukin-10/*blood ; Interleukin-6/*blood

A new, convenient, and rapid method for kinetic measurement of human fibrinolysis was established. The alteration of absorbance (A) in the process of blood coagulation and lyses was automatically scanned and recorded using a UV2000 spectrophotometer connected to a computer. The parameters of human fibrinolysis kinetics were established. Urokinase at 20 U/mL was the optimal concentration used. There was significant difference in fibrinolysis kinetics and plasma plasminogen concentration between 22 normal subjects and 27 patients with acute myeloblastic leukemia (P<0.05 and <0.01 respectively). The coefficience of variation was (5.24+/-1.51)%. This method could also be used to measure the plasma fibrinogen concentration at the same time. It was concluded that this method was stable and was capable of providing dynamic, direct experimental data and multiparemeters for clinicians. It was also valuable in evaluating the anti-and pro-fibrinolytic capcity of patients' plasmas, allowing for monitoring of therapy, choice of drugs and adjustment of drug concentrations.

Objective DryLab software was used to assist high performance liquid chromatography (HPLC) method to test and isolate six Cytochrome P450 (CYP450) probe substrates.Methods Six CYP450 probe substrates were selected and the right HPLC method was developed and validated with the assistance of DryLab software.Results The new HPLC method with the assistance of DryLab software could test and isolate six probe substrates with degrees of isolation more than 2.00. The correlation coefficients (R> 0.999 8) indicated high linear correlation between the concentrations and the peak areas among six probe substrates. Recovery studies showed good results for all the probe substrat from 86.38% to 110.29%. And therelative standard deviation (RSD) ranged from 1.69% to 3.80% with its intra-day and inter-day precision ranging from 0.42% to 2.01%, and 1.36% to 2.29%, respectively.Conclusions The developed HPLC method with the assistance of DryLab could test and isolate six probe substrates with shortertime than the HPLC method alone.

Objective To evaluate the significance of TF-PCA to the diagosis of DIC by observing changes of tissue factor(TF) and procoagulant activity (PCA) in patients with disseminated inravaascular coagulation(DIC)according to the enhancenment degree of whole blood leukocyte-derived TF expression and TF-PCA stimulated by Lipopolysaccharide (LPS). Method Patients with acute leukemia (AL) were included during hospitalization from Jan. 2005 to Jan. 2007 in Union Hospital of Huazhong University of Science and Technology. Recalcification time of LPS-stimulated whole blood was applied to evaluate tissue factor clotting time (TiFaCT) : anticoagulated whole blood was incubated at 37°C for a certain time with or without LlS-stimulation, and then the recalcitication time was measured. TF-PCA were evaluated based on the decreased degree of whole blood mcalcification time(△s).LSI)- t test and bivariate correlation analysis were analyzed by using the SPSS software package (version 13.0 for Windows). A P-value less than 0.05 was considered statistically significant. Results A retrospective and contrast analysis indicated that △s in patients with DIC and patients suspected with DIC were (95.2±68.6) and (85.8±16.9), respectively. When compared with normal controls(30.4±25.1 ), the difference both had extremely statistical significe(P<0.01). The results of TF mRNA detection and TF-PCA inhibitory experiments showed that the method of TiFaCT had a high sersitivity and specificity for determination of TF-PCA. Condusiots The levels of TF-PCA were obviously elevated after stimulated by LPS in patients with DIC or suspected with DIC.TiFaCT has an important clinical reference value for the diagnostic and prognostic evaluation of DIC.

Objective To investigate dynamic metabolism in vivo of Ginkgo Folium Tablet under the guidance of sequential metabolism thoughts. Methods In situ closed-loop in rats was carried out to study sequential metabolism of Ginkgo Folium Tablet through oral digestive system, namely to investigate and compare the intestinal flora metabolism, the gut wall metabolism and hepatic metabolism, combined with chromatographic fingerprint of blood samples. Results The analysis showed that 12 peaks in Ginkgo Folium Tablet were metabolized by intestinal flora, and 7 peaks generated through the gut wall. Most components of Ginkgo Folium Tablet were metabolized in liver, and 3 original medicine components were directly into the blood. Conclusion This study conducts a qualitative description of metabolism of Ginkgo Folium Tablet in different parts of the oral route, and provides references for the quality control, mechanism explanation and secondary development for Ginkgo Folium Tablet.

Objective To select the components for quality control of Fructus Lycii based on the absorption of its extract. Methods To investigate metabolism of components of Fructus Lycii, everted rat gut sacs was carried out as well as the blood was taken from abdominal aorta,.and all samples were analysised by HPLC. Results There are twelve constituents absorbed between ileum and jejunum of rat , and four constituents were detected in the blood. Compound 2, 3, 4, 5, 6, 9, 10, 11 were absorbed in prototype forms in the intestine directly,and compound 1, 7, 8, 12 were new ones. On the other hand, four compositions(3, 7, 10, 13)could be absorbed into blood through analysis serum samples obtaining from aorta abdominalis of rats. Two of them (3, 10)could be absorbed directly by intestine, while(7)was absorbed into blood in new form . Conclusion Based on the intestinal absorption experiment and analysion of compsition in blood, components (3, 10, 13) can be the quality control ingredients of Fructus Lycii.

Objective To study the multicomponent in vivo dynamic process in Chuanxiong Rhizoma;To elaborate in vivo metabolic profiling. Methods HPLC was used to establish the fingerprint of aqueous extract of Chuanxiong Rhizoma, and multicomponent changes were detected at the same time. Closed-loop intestine method was used to study the multicomponent changes of oral administration of Chuanxiong Rhizoma after stomach-intestine-liver process. Results Totally 17 components were detected in the fingerprint of aqueous extract of Chuanxiong Rhizoma and they were basically stable in the digestive juice. For in vivo metabolism, 4 components were metabolized by intestinal flora;3 components were metabolized by liver;2 new components were the metabolites of intestinal flora;1 component was the metabolite of liver. Conclusion Multicomponent sequential metabolism and closed-loop intestine method were used to clarify that multicomponent metabolic profiling was feasible, and it could provide experimental basis for the metabolism of traditional Chinese medicine.

This study examined the changes of activities of vitamin K-dependent clotting factors (VKDCF) under various pathological conditions and explored the relationship between acquired deficiency of VKDCFs and hemorrhage. Clinical data of 35 patients who were diagnosed as having acquired deficiency of VKDCF were retrospectively analyzed. Coagulation factors involved in the intrinsic and extrinsic pathways were detected in these patients and 41 control subjects. The results showed that the average activities of VKDCFs were decreased in the patients in comparison to the control subjects and significantly increased after treatment of these patients with vitamin K and blood products. Multivariate regression analysis indicated that decreased activity of VKDCF was not an independent risk factor for bleeding disorders owing to deficiency or metabolic disturbance of vitamin K. It was concluded that acquired deficiency of VKDCF occurs under a variety of pathologic conditions and is closely associated with hemorrhagic events. Administration of vitamin K and transfusion of blood products containing high concentrations of VKDCFs helps alleviate the hemorrhagic diseases.