Objective Heparanase can specifically cleave carbohydrate chains of heparan sulphate proteoglycans, which is an important component of the extracellular matrix. This study was designed to investigate the expression of heparanase in patients with colorectal cancer, and to analyze its relationships with progression of the cancer and clinical prognosis. Methods Samples were collected from 36 patients with colorectal cancers from 2003 to 2004 in Peking Union Medical College Hospital, and were embeded by Paraffin and fresh-frozened. The expression of heparanase mRNA and its protein were measured by RT-PCR and immunohistochemistry. The relationships between these expressions and the clinicopathologic information (tumor invasion, tumor differentiation, lymph node involvement, accompanying with colorectal adenoma and 2-year survival) were also evaluated. Results The expressions of heparanase mRNA in colorectal cancer (19/31， 61.3%) were significantly higher than those in normal colorectal tissues (6.5%). The overexpressions in normal tissues were positively correlated to the incidence of adenoma in patients with colorectal cancer （r=0.352， P=0.024）. The result of immunohistochemistry also showed that heparanase mainly expressed in the vascular endothelium within cancer tissues and the peripheral invased region outside cancer tissues. The 2-year disease-free-survival in patients with negative heparanase expression (88.9%) was higher than that with positive heparanase expression (50.0%), but there was no significant difference （P=0.078）. Conclusion Heparanase overexpressed in colorectal cancer tissues, and thus it may take a role as an indicator for the formation and prognosis of colorectal cancer.
ObjectiveTo evaluate efficacy and safety of early anticoagulation therapy with low molecular weight heparin (LMWH) in prevention of venous thromboembolism (VTE) after pancreatoduodenectomy (PD).MethodsThe patients who received PD in our hospital from January 2017 to December 2018 were collected retrospectively, then were divided into the anticoagulant group and the non-anticoagulant group. The operation time, intraoperative blood loss, tumor property, coagulation function indexes such as prothrombin time (PT), PT activity (PTA), fibrinogen (FIB), activated partial thromboplastin time (APTT), thrombin time (TT), and D-dimer (DD), platelet (PLT), VTE, bleeding related complications etc. were compared between the two groups.ResultsA total of 103 patients underwent PD were included in this study, including 52 patients in the anticoagulant group and 51 patients in the non-anticoagulant group. There were no significant differences in the baseline data such as the gender, age, and preoperative coagulation function indexes, etc. between the two groups (P>0.05). The incidence of VTE in the anticoagulant group was lower than that in the non-anticoagulant group (13.5% versus 47.1%, P<0.001). There was no significant difference in the incidence of bleeding between the anticoagulant group and the non-anticoagulant group (9.6% versus 7.8%, P>0.05). There were no statistically significant differences in the coagulation indexes between the two groups before operation and day 1 after operation (P>0.05). On day 8 after operation, the FIB and DD values of the anticoagulant group were significantly lower than those of the non-anticoagulant group (P values were 0.040 and 0.002, respectively). A comparison of different phases in the same group on coagulation indexes between day 8 and day 1 after surgery showed that there were statistically significant differences (P<0.05), the changes of all indexes were within the normal range.ConclusionThe results of this study indicate that LMWH administered at 24 h after PD could decrease incidence of VTE and don’t increase risk of bleeding.
Objectives To explore the characteristics of thrombosis in critically ill patients with Omicron infection and the therapeutic value of prophylactic low molecular weight heparin (LMWH) treatment. MethodsA single center, retrospective cohort study included critically ill adult patients with Omicron variant of SARS-CoV-2 admitted to Peking University Third Hospital from December 7, 2022, to February 8, 2023. The patients were categorized into two groups based prophylactic LMWH. Propensity score (PS) matching was used to match patients (1: 1 ratio) based on the predefined criteria. General clinical information and laboratory parameters were compared. This study was retrospectively registered at Chinese Clinical Trail Registry (ChiCTR2300067434). ResultsFour hundred and fifty-two patients and 360 patients were included before and after PS matching. There were no statistical differences in mortality, the incidence of pulmonary embolism, arterial thrombosis or bleeding between the anticoagulation group and non-coagulation group before and after PS matching. There were 91 thrombotic events in 82 patients (18.14%), of which 54 cases (59.34%) were lower limb intermuscular vein thrombosis, 3 cases (3.30%) were pulmonary embolism, 14 cases (15.38%) were acute myocardial infarction and 3 cases (3.30%) were acute cerebral infarction. The thrombotic event resulted in the death of 5 patients. D-dimer increased in 385 cases (85.56%). On the 1st, 3rd, 6th and 9th day, the concentration of D-dimer in the anticoagulant group was higher than that in the non-anticoagulant group (P=0.006, 0.001, 0.024 and 0.006, respectively). ConclusionsAlthough thrombosis and coagulation disorders are still common complications of COVID-19, it is not the direct cause of most death in COVID-19 patients caused by Omicron. The role of prophylactic anticoagulation treatment for Omicron-infected patients needs further study.
Objective According to heparanase’s gene sequence of GenBank, to construct heparanase gene-targeted small interfering RNA (siRNA) and its expression vector and to observe its interference effect on the expression of heparanase gene in human malignant breast cancer MDA-MB-231 cell. Methods Heparanase gene-targeted hairpin siRNA was designed, two complementary oligonucleotide strands were synthesized and inserted into pGPU6/GFP/Neo vector, which was identified by sequence identify. Human malignant breast cancer MDA-MB-231 cell was transfected with the constructed vector with lipofectamine method. Fluorescence photograph was taken. Real-time PCR (RT-PCR) was performed to evaluate the level of heparanase mRNA expression. Results Four kinds of heparanase gene-targeted hairpin siRNA were designed, then were inserted into pGPU6/GFP/Neo vector after annealing. Sequencing indicated the construction was successful. Fluorescence photographs showed MDA-MB-231 cells were transfected successfully. RT-PCR showed that heparanase mRNA expression levels were inhibited significantly （Plt;0.05）. Conclusion The heparanase gene-targeted siRNA and its vector are successfully constructed and MDA-MB-231 cells are transfected successfully. Heparanase mRNA expression levels are significantly inhibited by siRNA vector, which provide a new method for the treatment of cancer.
目的探讨低分子肝素预防下肢静脉曲张术后深静脉血栓形成的临床效果。 方法将2011年1月至2013年12月期间于笔者所在医院行大隐静脉高位结扎＋分段剥脱术＋腔内激光闭合术的513例下肢静脉曲张患者随机分为2组：低分子肝素组238例，下肢静脉曲张术后采用低分子肝素预防性治疗；对照组275例，术后不采用任何抗凝药物。比较2组患者深静脉血栓形成和并发症发生情况。 结果低分子肝素组发生浸透敷料的出血14例（5.9%），切口出血或皮下血肿25例（10.5%），血小板减少1例（0.4%），肝功能异常2例（0.8%），无深静脉血栓形成发生；对照组发生浸透敷料的出血19例（6.9%），切口出血或皮下血肿27例（9.8%），肝功能异常2例（0.7%），深静脉血栓形成7例（2.5%），无血小板减少发生。2组患者浸透敷料的出血、切口出血或皮下血肿、血小板减少及肝功能异常发生率比较差异均无统计学意义（P＞0.05），但低分子肝素组深静脉血栓形成的发生率低于对照组（P＜0.05）。术后获访487例，随访时间为4～12个月，平均10个月。其中低分子肝素组获访225例，对照组获访262例。获访患者随访期间发生下肢静脉曲张复发9例（低分子肝素组4例，对照组5例），隐神经损伤11例（低分子肝素组5例，对照组6例），无远期下肢深静脉血栓形成病例。2组患者的下肢静脉曲张复发率和隐神经损伤发生率比较差异均无统计学意义（P＞0.05）。 结论采用低分子肝素预防下肢静脉曲张术后下肢深静脉血栓形成具有良好的临床效果和安全性，值得临床推广应用。
Objective To systematically review the effectiveness and model building process of heparin treatment for animal model with smoke inhalation injury. Methods Databases including PubMed, EMbase, CBM, CNKI, VIP and WanFang Data were searched to collect animal experiments about the treatment of heparin for animal model with smoke inhalation injury from inception to November 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then meta-analysis was conducted by RevMan 5.3 software. Results A total of nine studies involving 11 animal experiments were included. The results showed that building animal model with smoke inhalation injury were through burning of cotton towels or pine sawdust by sheep or rats below 40℃. The results of meta-analysis showed that there was no significant difference in mortality rate between two groups (heparin group vs. control group: RR=0.38, 95%CI 0.14 to 1.05, P=0.06; heparin plus DMSO group vs. DMSO group: RR=0.10, 95%CI 0.01 to 1.51, P=0.10). In addition, the pulmonary artery pressure (MD=–3.31, 95%CI –4.51 to –2.11, P<0.000 01), wet to dry weight ratio (MD=–0.90, 95%CI –1.19 to –0.61, P<0.000 01), and lung water content (MD=–1.18, 95%CI –1.67 to –0.70, P<0.000 01) of the experimental group were lower than those in the control group. PaO2/FiO2 after 12 hours (MD=131.00, 95%CI 59.54 to 202.46, P=0.000 3), PaO2/FiO2 after 24 hours (MD=114.00, 95%CI 60.56 to 167.44, P<0.000 1), PaO2/FiO2 after 48 hours (MD=46.00, 95%CI 20.62 to 71.38, P=0.000 4) were higher than those in the control group. However, there was no significant difference in coagulation function between both groups. Conclusion The current evidence shows that the establishment of animal model of smoke inhalation injury is still lack of standard method. Heparin can decrease pulmonary artery pressure and lung water content in animal models with smoke inhalation injury. Due to the limited quality and quantity of included studies, the above conclusions are still needed to be verified by more high quality studies.
Objective To analyze the effect of arteriovenous impulse system (AVIS) combined with lowmolecular-weight heparins calcium (LMWHC) for prophylaxis of deep vein thrombosis (DVT) following total knee arthroplasty (TKA). Methods From March 2006 to March 2008, 76 cases of osteoarthritis patients (76 knees) accepted TKA, including 25 males and 51 females with an average age of 66.6 years (range, 58-79 years). The affected knees were left side in 41 cases and right side in 35 cases. They were randomly divided into experimental group and control group before surgery. Then LMWHC and rehabil itation training were routinely given in two groups before and after surgery. However, only experimental group was treated with AVIS continually during the first four days and then two times a day for 30 minutes one time during 5-7 days. At 7 daysd after operation, color Doppler ultrasound was used to detect the occurrence condition of DVT. Results Five cases (13.16%) had thrombosis of calf and recovered after treated with urokinase and salvia in the experimental group. Eleven cases had thrombosis of calf and 3 cases had thrombosis of whole low extremities (36.84%), and improved after treated with urokinase and salvia in the control group. There was significant difference in DVT incidencerate between two groups (P lt; 0.05). No pulmonary embol ism or death was found in both groups. Conclusion AVIScan effectively accelerate the venous blood return velocity, a combination of AVIS and LMWHC has a better effect in theprevention of DVT following TKA.