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Antithrombin deficiency and decreased protein C activity in a young man with venous thromboembolism:

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《医学前沿（英文）》 2018年 第12卷 第3期   页码 319-323 doi: 10.1007/s11684-017-0553-4

摘要：

Antithrombin and protein C are two crucial members in the anticoagulant system and play important roles in hemostasis. Mutations in and lead to deficiency or dysfunction of the two proteins, which could result in venous thromboembolism (VTE). Here, we report a Chinese 22-year-old young man who developed recurrent and serious VTE in cerebral veins, visceral veins, and deep veins of the lower extremity. Laboratory tests and direct sequencing of and were conducted for the patient and his family members. Coagulation tests revealed that the patient presented type I antithrombin deficiency combined with decreased protein C activity resulting from a small insertion mutation c.848_849insGATGT in and a short deletion variant c.572_574delAGA in . This combination of the two mutations was absent in 400 healthy subjects each from southern and northern China. Then, we summarized all the mutations of the and gene reported in the Chinese Han population. This study demonstrates that the combination of antithrombin deficiency and decreased protein C activity can result in severe VTE and that the coexistence of different genetic factors may increase the risk of VTE.

关键词： antithrombin deficiency     protein C activity     mutation     variant     venous thromboembolism     anticoagulants    

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Venous thromboembolism in children with acute lymphoblastic leukemia in China: a report from the Chinese

《医学前沿（英文）》 2023年 第17卷 第3期   页码 518-526 doi: 10.1007/s11684-022-0958-6

摘要： Venous thromboembolism (VTE) is a complication in children with acute lymphoblastic leukemia (ALL). The Chinese Children’s Cancer Group-ALL-2015 protocol was carried out in China, and epidemiology, clinical characteristics, and risk factors associated with VTE were analyzed. We collected data on VTE in a multi-institutional clinical study of 7640 patients with ALL diagnosed in 20 hospitals from January 2015 to December 2019. First, VTE occurred in 159 (2.08%) patients, including 90 (56.6%) during induction therapy and 108 (67.92%) in the upper extremities. T-ALL had a 1.74-fold increased risk of VTE (95% CI 1.08–2.8, P = 0.022). Septicemia, as an adverse event of ALL treatment, can significantly promote the occurrence of VTE (P < 0.001). Catheter-related thrombosis (CRT) accounted for 75.47% (n = 120); and, symptomatic VTE, 58.49% (n = 93), which was more common in patients aged 12–18 years (P = 0.023), non-CRT patients (P < 0.001), or patients with cerebral thrombosis (P < 0.001). Of the patients with VTE treated with anticoagulation therapy (n = 147), 4.08% (n = 6) had bleeding. The VTE recurrence rate was 5.03% (n = 8). Patients with VTE treated by non-ultrasound-guided venous cannulation (P = 0.02), with residual thrombus (P = 0.006), or with short anticoagulation period (P = 0.026) had high recurrence rates. Thus, preventing repeated venous puncture and appropriately prolonged anticoagulation time can reduce the risk of VTE recurrence.

关键词： acute lymphoblastic leukemia     child     venous thromboembolism     epidemiology     clinical characteristic     risk factor    

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Clinical and genetic risk factors for venous thromboembolism in Chinese population

Chen WANG PhD, MD, Zhen-Guo ZHAI PhD, MD, Ying H. SHEN PhD, MD, Lan ZHAO PhD, MD,

《医学前沿（英文）》 2010年 第4卷 第1期   页码 29-35 doi: 10.1007/s11684-010-0012-y

摘要： Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, carries significant mortality and morbidity. The most important and effective way to reduce VTE incidence is to identify the patients at risk and give necessary prevention. VTE is a multifactorial and complicated disorder. Major risk factors for VTE include surgery and trauma, acute medical illness, active cancer and pregnancy. Genetic factors increase susceptibility to the disease and are useful in predicting the development of VTE. Gene-gene and gene-environment interactions alter and magnify the clinical picture in this disorder. This brief review summarizes some selected clinical and genetic risk factors for VTE based on the current research in China.

关键词： risk factor     stroke     prothrombin     plasminogen activator inhibitor type-1     polymorphism     thrombophilia     biomarker    

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Piezoelectric pump with flexible venous valves for active cell transmission

《机械工程前沿（英文）》 2022年 第17卷 第4期 doi: 10.1007/s11465-022-0712-4

摘要： The development of organ-on-a-chip systems demands high requirements for adequate micro-pump performance, which needs excellent performance and effective transport of active cells. In this study, we designed a piezoelectric pump with a flexible venous valve inspired by that of humans. Performance test of the proposed pump with deionized water as the transmission medium shows a maximum output flow rate of 14.95 mL/min when the input voltage is 100 V, and the pump can transfer aqueous solutions of glycerol with a viscosity of 10.8 mPa·s. Cell survival rate can reach 97.22% with a yeast cell culture solution as the transmission medium. A computational model of the electric-solid-liquid multi-physical field coupling of the piezoelectric pump with a flexible venous valve is established, and simulation results are consistent with experimental results. The proposed pump can help to construct the circulating organ-on-a-chip system, and the simple structure and portable application can enrich the design of microfluidic systems. In addition, the multi-physical field coupling computational model established for the proposed piezoelectric pump can provide an in-depth study of the characteristics of the flow field, facilitating the optimal design of the micro-pump and providing a reference for the further study of active cell transport in organ-on-a-chip systems.

关键词： venous valve     flexible venous valve     cell transmission     organ-on-a-chip system     piezoelectric device    

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Classification and treatment of orbital venous malformations: an updated review

Tianyuan Li, Renbing Jia, Xianqun Fan

《医学前沿（英文）》 2019年 第13卷 第5期   页码 547-555 doi: 10.1007/s11684-018-0623-2

摘要： Orbital venous malformation (OVM) is a congenital vascular disease. As a common type of vascular malformation in the orbit, OVM may result in vision deterioration and cosmetic defect. Classification of orbital vascular malformations, especially OVMs, is carried out on the basis of different categories, such as angiogenesis, hemodynamics, and locations. Management of OVM is complicated and challenging. Treatment approaches include sclerotherapy, laser therapy, embolization, surgical resection, and radiotherapy. A satisfactory outcome can be achieved only by selecting the appropriate treatment according to lesion characteristics and following the sequential multi-method treatment strategy. This article summarizes the current classification and treatment advances in OVM.

关键词： orbit     venous malformation     treatment     sclerotherapy     laser     embolization    

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Effects of combined procedure and devascularization alone on hyperdynamics of the portal venous system

HUA Rong, SUN Yongwei, WU Zhiyong

《医学前沿（英文）》 2008年 第2卷 第3期   页码 244-247 doi: 10.1007/s11684-008-0046-6

摘要： Shunts and devascularizations have totally different effects on the hemodynamics of the portal venous system. The actual results of pericardial devascularization (PCDV) alone and conventional splenorenal shunt combined with pericardial devascularization (combined procedure, CP) should be determined by more clinical observations. This study aimed to evaluate effects on hemodynamics in the portal venous system after CP and PCDV only. In 20 patients who received CP and 18 who received PCDV, hemodynamic parameters of the portal venous system were studied by magnetic resonance angiography 1 week before and 2 weeks after operation. Free portal pressure (FPP) was continuously detected by a transducer during the operations. Compared to the preoperative data, a decreased flow in the portal vein (PVF) [(563.12 ± 206.42) mL/min (1080.63 ± 352.85) mL/min, < 0.05], a decreased portal vein diameter (PVD) [(1.20 ± 0.11) cm (1.30 ± 0.16) cm, < 0.01], a decreased FPP [(21.50 ± 2.67) mmHg (29.88 ± 2.30) mmHg, < 0.01] and an increased flow in the superior mesenteric vein (SMVF) [(1105.45 ± 309.03) mL/min (569.13 ± 178.46) mL/min, < 0.05] were found in the CP group after operation; a decreased PVD [(1.27 ± 0.16) cm (1.40 ± 0.23) cm, < 0.05], a decreased PVF [(684.60 ± 165.73) mL/min (1175.64 ± 415.09) mL/min, < 0.05], a decreased FPP [(24.40 ± 3.78) mmHg (28.80 ± 3.56) mmHg, < 0.05] and an increased SMVF [(697.91 ± 121.83) mL/min (521.30 ± 115.82) mL/min, < 0.05] were observed in the PCDV group. After operation, PVF in the CP group [(563.12 ± 206.42) mL/min (684.60 ± 165.73) mL/min, > 0.05] had no significant decrease, while FPP [(21.50 ± 2.67) mmHg (24.40 ± 3.78) mmHg, < 0.01] had a significant decrease as compared with that in the PCDV group. PVF and FPP could be decreased by both surgical procedures, but the effect of decreasing FPP was much better in the combined procedure than in PCDV alone. Further, there was no significant difference in PVF between the two groups. It is suggested that the combined surgical procedure could integrate the advantages of shunting with those of devascularization, as well as maintaining the normal anatomic structure of hepatic portal system, thus it should be one of the best choices for patients with portal hypertension when surgical interventions are considered.
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Epidemiology, pathogenesis, and management of coronavirus disease 2019-associated stroke

《医学前沿（英文）》 doi: 10.1007/s11684-023-1041-7

摘要： The coronavirus disease 2019 (COVID-19) epidemic has triggered a huge impact on healthcare, socioeconomics, and other aspects of the world over the past three years. An increasing number of studies have identified a complex relationship between COVID-19 and stroke, although active measures are being implemented to prevent disease transmission. Severe COVID-19 may be associated with an increased risk of stroke and increase the rates of disability and mortality, posing a serious challenge to acute stroke diagnosis, treatment, and care. This review aims to provide an update on the influence of COVID-19 itself or vaccines on stroke, including arterial stroke (ischemic stroke and hemorrhagic stroke) and venous stroke (cerebral venous thrombosis). Additionally, the neurovascular mechanisms involved in SARS-CoV-2 infection and the clinical characteristics of stroke in the COVID-19 setting are presented. Evidence on vaccinations, potential therapeutic approaches, and effective strategies for stroke management has been highlighted.

关键词： SARS-CoV-2     ischemic stroke     stroke     hemorrhagic stroke     cerebral venous thrombosis     vaccination    

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Association between ICU quality and in-hospital mortality of V-V ECMO-supported patients—the ECMO quality improvement action (EQIA) study: a national cohort study in China from 2017 to 2019

《医学前沿（英文）》 doi: 10.1007/s11684-023-1014-x

摘要： This cohort study was performed to explore the influence of intensive care unit (ICU) quality on in-hospital mortality of veno-venous (V-V) extracorporeal membrane oxygenation (ECMO)-supported patients in China. The study involved all V-V ECMO-supported patients in 318 of 1700 tertiary hospitals from 2017 to 2019, using data from the National Clinical Improvement System and China National Critical Care Quality Control Center. ICU quality was assessed by quality control indicators and capacity parameters. Among the 2563 V-V ECMO-supported patients in 318 hospitals, a significant correlation was found between ECMO-related complications and prognosis. The reintubation rate within 48 hours after extubation and the total ICU mortality rate were independent risk factors for higher in-hospital mortality of V-V ECMO-supported patients (cutoff: 1.5% and 7.0%; 95% confidence interval: 1.05–1.48 and 1.04–1.45; odds ratios: 1.25 and 1.23; P = 0.012 and P = 0.015, respectively). Meanwhile, the V-V ECMO center volume was a protective factor (cutoff of ≥ 50 cases within the 3-year study period; 95% confidence interval: 0.57–0.83, odds ratio: 0.69, P = 0.0001). The subgroup analysis of 864 patients in 11 high-volume centers further strengthened these findings. Thus, ICU quality may play an important role in improving the prognosis of V-V ECMO-supported patients.

关键词： veno-venous extracorporeal membrane oxygenation     in-hospital mortality     high-volume centers     quality control     intensive care unit capacity parameters    

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标题 作者 时间 类型 操作

Antithrombin deficiency and decreased protein C activity in a young man with venous thromboembolism:

null

期刊论文

Venous thromboembolism in children with acute lymphoblastic leukemia in China: a report from the Chinese

期刊论文

Clinical and genetic risk factors for venous thromboembolism in Chinese population

Chen WANG PhD, MD, Zhen-Guo ZHAI PhD, MD, Ying H. SHEN PhD, MD, Lan ZHAO PhD, MD,

期刊论文

Piezoelectric pump with flexible venous valves for active cell transmission

期刊论文

Classification and treatment of orbital venous malformations: an updated review

Tianyuan Li, Renbing Jia, Xianqun Fan

期刊论文

Effects of combined procedure and devascularization alone on hyperdynamics of the portal venous system

HUA Rong, SUN Yongwei, WU Zhiyong

期刊论文

Epidemiology, pathogenesis, and management of coronavirus disease 2019-associated stroke

期刊论文

Association between ICU quality and in-hospital mortality of V-V ECMO-supported patients—the ECMO quality improvement action (EQIA) study: a national cohort study in China from 2017 to 2019

期刊论文