Clinical Hemorheology and Microcirculation - Volume 84, issue 3

Authors: Xu, Wei-Chen | Sun, Li-Ping | Xu, Hui-Xiong | Wang, Qiao

Article Type: Research Article

Abstract: Sclerosing angiomatoid nodular transformation (SANT) is an uncommon non-tumorous disease of the spleen. The low morbidity and non-specific clinical symptoms of SANT might cause a misdiagnosis. The present study reported a case of a 31-year-old female with a SANT of the spleen. Findings on clinical manifestations and examinations, especially on contrast-enhanced ultrasound (CEUS), were carefully analyzed, and relevant literatures have also been reviewed.

Keywords: Scleroring angiomatoid nodular transformation, spleen, contrast-enhanced ultrasound

DOI: 10.3233/CH-221601

Citation: Clinical Hemorheology and Microcirculation, vol. 84, no. 3, pp. 237-245, 2023

Authors: Zhou, Ziying | Hu, Qian | Guo, Hongmei | Wang, Xijia

Article Type: Research Article

Abstract: BACKGROUND: Circular RNA (circRNA) has been found to play an important role in the progression of many diseases, including ischemic stroke. However, the regulatory mechanism of circSEC11A in ischemic stroke progression need to further investigation. METHODS: Human brain microvascular endothelial cells (HBMECs) were stimulated by oxygen glucose deprivation (OGD). CircSEC11A, SEC11A mRNA and miR (microRNA)-29a-3p were quantified by quantitative real-time PCR (qRT-PCR). SEMA3A, BAX and BCL2 protein level was quantified by western blot. Oxidative stress, cell proliferation, angiogenesis and apoptosis abilities were gauged by oxidative stress assay kit, 5-Ethynyl-2’-Deoxyuridine (EdU) staining, tube formation assay and flow cytometry assays, …respectively. Direct relationship between miR-29a-3p and circSEC11A or SEMA3A was validated by dual-luciferase reporter assay, RIP assay and RNA pull-down assay. RESULTS: CircSEC11A was upregulated in OGD-induced HBMECs. OGD promoted the oxidative stress and apoptosis and inhibited cell proliferation and angiogenesis, while circSEC11A knockdown relieved the effects. CircSEC11A functioned as the sponge for miR-29a-3p, and miR-29a-3p inhibitor reversed the effects of si-circSEC11A on OGD-induced HBMECs oxidative injuries. Moreover, SEMA3A served as the target gene of miR-29a-3p. MiR-29a-3p inhibition ameliorated OGD-induced HBMECs oxidative injuries, while SEMA3A overexpression rescued the impacts of miR-29a-3p mimic. CONCLUSION: CircSEC11A promoted the malignant progression in OGD-induced HBMECs through the mediation of miR-29a-3p/SEMA3A axis. This study has provided the new insight into the underlying application of circSEC11A in cell model of ischemic stroke. Show more

Keywords: OGD, HBMECs, ischemic stroke, circSEC11A, miR-29a-3p

DOI: 10.3233/CH-221689

Citation: Clinical Hemorheology and Microcirculation, vol. 84, no. 3, pp. 247-262, 2023

Authors: Wu, Xincai | Zhang, Xin | Wang, Keke | Zhao, Shuangshuang | Shang, Mengyuan | Duan, Ran | Zhang, Zheng | Chen, Baoding

Article Type: Research Article

Abstract: OBJECTIVE: Our research sought to investigate the relationship between initial ablation ratio (IAR) and internal composition of benign thyroid nodules treated by microwave ablation (MWA). MATERIALS AND METHODS: Patients who underwent MWA at the Affiliated Hospital of Jiangsu University from January 2018 to December 2022 were enrolled in our research. All the patients were followed up for at least one year. We analyzed the relationship between IAR at 1 month of solid nodules (solid >90%), predominantly solid nodules (90% >solid > 75%), mixed solid alongside cystic nodules (75% >solid > 50%) as well as volume reduction rate (VRR) at 1, 3, …6 and 12 months follow-up. OBJECTIVE: The mean IAR of the solid nodules (solid >90%) was 94.32±7.87%,#x0025;, that of the predominantly solid nodules (90% >solid > 75%) and mixed solid alongside cystic nodules (75% >solid > 50%) were 86.51±6.66% and 75.19±4.97%,#x0025;, respectively. Almost all the thyroid nodules were significantly decreased in size after MWA. After 12 months of MWA treatment, the average volume of the aforementioned thyroid nodules decreased from 8.69±8.79 to 1.84±3.11 ml, 10.94±9.07 to 2.58±3.34 ml, 9.92±6.27 to 0.25±0.42 ml, respectively. The mean symptom and cosmetic scores of the nodules showed significant (p  < 0.000) improvement. The rates of the complications or side effects of MWA against the above-mentioned nodule types were 8.3% (3/36), 3.2% (1/31) and 0% (0/36), respectively. CONCLUSIONS: The application of the IAR to quantify the success rate of thyroid nodule microwaves in the short term demonstrated that IAR was related to the internal components of the nodule. Although the IAR was not high when the thyroid component was mixed solid and cystic nodules (75% >solid > 50%), the final therapeutic effect was still satisfactory. Show more

Keywords: Initial ablation ratio, thyroid nodules, microwave ablation, internal components, volume reduction rate

DOI: 10.3233/CH-231699

Citation: Clinical Hemorheology and Microcirculation, vol. 84, no. 3, pp. 263-273, 2023

Authors: Liu, Lingling | Chen, Lin | Zhao, Caihan | Fan, Ruifang | Tang, Qing | Yuan, Qing | Du, Wei | Liu, Xiangfu

Article Type: Research Article

Abstract: INTRODUCTION: This study retrospectively analyzed a total of 86 leukapheresis treatments in 55 patients with hyperleukocytic leukemia (HLL). METHODS: In the leukapheresis treatments, the monitoring collection (MNC) program in COBE spectra continuous flow centrifuge (CFC) for blood component separator was used. RESULTS: In this study, the white blood cell (WBC) suspension volume collected in leukapheresis treatment were 870.72±208.40 mL, and significantly larger than that reported in previous study. Compared with before leukapheresis, there were no difference in patient with HLL on the peripheral blood platelet (PLT) count and hemoglobin (HGB) levels. The index plasma fibrinogen (FIB) concentration …was slightly reduced by leukapheresis, however, it did not affect a lot the maintenance of normal hemostatic function in patients with HLL. DISCUSSION: Our data provided evidences that large-volume leukapheresis had no obvious effects on HGB level and coagulation functions in patient with HLL. So large-volume leukapheresis by CFC could be widely used in clinic. Show more

Keywords: Leukapheresis, hemoglobin, platelet, coagulation, hyperleukocytic leukemia

DOI: 10.3233/CH-231737

Citation: Clinical Hemorheology and Microcirculation, vol. 84, no. 3, pp. 275-281, 2023

Authors: Abdelwahed, Omaima Mohammed | Aboulhoda, Basma Emad | Awadallah, Maryse Youssef | Gouda, Sarah Ali Abdelhameed | Abdallah, Hend | Rashed, Laila | Khaled, Mai | Ghobrial, Emad E. | Alghabban, Hadel M. | Sharawy, Nivin

Article Type: Research Article

Abstract: BACKGROUND: Acute kidney injury (AKI) is a common complication of sepsis, with the burden of long hospital admission. Early prediction of AKI is the most effective strategy for intervention and improvement of the outcomes. OBJECTIVE: In our study, we aimed to investigate the predictive performance of the combined model using ultrasound indices (grayscale and Doppler indieces), endothelium injury (E-selectin, VCAM-1, ICAM1, Angiopoietin 2, syndecan-1, and eNOS) as well as inflammatory biomarkers (TNF-a, and IL-1β) to identify AKI. METHODS: Sixty albino rats were divided into control and lipopolysaccharide (LPS) groups. Renal ultrasound, biochemical and …immunohistological variables were recorded 6 hrs, 24 hrs, and 48 hrs after AKI. RESULTS: Endothelium injury and inflammatory markers were found to be significantly increased early after AKI, and correlated significantly with kidney size reduction and renal resistance indices elevation. CONCLUSIONS: Using area under the curve (AUC), the combined model was analyzed based on ultrasound and biochemical variables and provided the highest predictive value for renal injury. Show more

Keywords: Ultrasound, kidney, endothelium, inflammation, predictive, fibrosis

DOI: 10.3233/CH-231754

Citation: Clinical Hemorheology and Microcirculation, vol. 84, no. 3, pp. 283-301, 2023

Authors: Cui, Shaohua | Liang, Chaoyue | Geng, Lixia

Article Type: Research Article

Abstract: Background: Thrombotic thrombocytopenic purpura (TTP) are a group of microvascular thrombohemorrhagic syndromes with low incidence and high mortality, which are characterized by thrombocytopenia, microangiopathic hemolytic anemia, fever, neuropsychiatric disorders, and renal involvement. In addition, TTP has a high rate of misdiagnosis and underdiagnosis due to the lack of specific clinical manifestations. Case report: A male patient aged 47 years was admitted to our hospital with complaints of dizziness and nausea for 2 days and soy-colored urine for 1 day. The patient had caught a cold and suffered from fever, dizziness, and nausea 2 days before admission. These symptoms …were relieved by self-administration of berberine 1 day before admission. Later, the patient found that the urine was scanty and soy-colored. Physical examination on admission showed that the patient developed apathy, with occasional babbling, yellowing skin and sclera, and scattered bleeding spots on the anterior chest area. Based on auxiliary tests combined with clinical manifestations, the patient was diagnosed with TTP and administered plasma exchange, hemofiltration, hormone, and anti-platelet therapies. The patient recovered and was discharged after 3 weeks. The patient regularly took aspirin and was followed up one year later with no recurrence. Conclusion: TTP is an acute severe disease with complex etiology, abrupt onset, and dangerous conditions. In this patient with TTP, an important cause of the disease may have been an acute gastrointestinal infection. The plasma examination in another hospital revealed positive results for ADAMTS13 inhibitors, providing strong evidence for the diagnosis of this case. Multiple plasma exchanges and glucocorticoids yielded favorable treatment results and were critical measures of successful treatment of TTP. Show more

Keywords: Microangiopathic hemolytic anemia, thrombocytopenia, thrombotic thrombocytopenic purpura

DOI: 10.3233/CH-231784

Citation: Clinical Hemorheology and Microcirculation, vol. 84, no. 3, pp. 303-308, 2023

Authors: Erkens, Ralf | Duse, Dragos | Wernly, Bernhard | Flaatten, Hans | Fjølner, Jesper | Bruno, Raphael Romano | Wolff, Georg | Artigas, Antonio | Kelm, Malte | Beil, Michael | Sviri, Sigal | Schaller, Stefan J. | Fuest, Kristina | Szczeklik, Wojciech | Piayda, Kerstin | Elhadi, Muhammed | Joannidis, Michael | Nedergaard, Helene Korvenius | Oeyen, Sandra | Moreno, Rui | Leaver, Susannah | de Lange, Dylan W. | Guidet, Bertrand | Jung, Christian

Article Type: Research Article

Abstract: Aims: Anemia is common in the old and often observed in critically ill patients. Increased age is associated with higher mortality following a COVID-19 infection, making old patients prone to poor outcomes. We investigated whether anemia at admission to the ICU or the need for blood transfusion was associated with 90-day mortality in older, critically ill COVID-19 patients. Methods: In this prospective multicenter study, the 90-day mortality of COVID-19 patients≥70 years treated in 138 intensive care units (ICU) was analyzed. Associations between anemia (WHO definition) at admission and discharge from ICU and the use of red blood cell …(RBC) transfusions with mortality were assessed. Hemoglobin thresholds of RBC transfusions in old, critically ill COVID-19 patients were recorded. Results: In 493 patients (350 anemic, 143 non-anemic), anemia (WHO definition) at the time of ICU admission was not associated with impaired overall survival. Transfusion and severe anemia (hemoglobin≤10 g/dL) at ICU discharge were independently associated with a higher risk of 90-day mortality. Conclusion: The need for red blood cell transfusions and severe anemia at ICU discharge, but not at the timepoint of admission, were independently associated with 90-day mortality in critically-ill old COVID-19 patients. Show more

Keywords: Anaemia, transfusion, frailty, COVID-19

DOI: 10.3233/CH-231790

Citation: Clinical Hemorheology and Microcirculation, vol. 84, no. 3, pp. 309-320, 2023

Authors: Chen, Jia-Hao | Zhou, Hang | Zhang, Qiang | Wang, Hu | Hidig, Sakarie Mustafe | Chen, Xiang-Yang | Feng, Shuo

Article Type: Research Article

Abstract: BACKGROUND: The main objective of this study was to predict the status of blood and the occurrence of lower limb deep vein thrombosis (DVT) after total knee arthroplasty(TKA) by means of mean platelet volume (MPV) combined with thromboelastography (TEG). METHODS: We collected 180 patients who underwent unilateral total knee arthroplasty between May 2015 and March 2022, and the patients were divided into DVT group and control group according to whole-leg ultrasonography on the seventh postoperative day. Blood count and TEG were performed on the day before surgery, the first day after surgery and the seventh day …respectively. Multifactorial analysis was used to investigate whether the relevant parameters were independent predictors of DVT after TKA. RESULTS: MPV has the strongest correlation with the maximum amplitude (MA), followed by alpha-angle; MPV and alpha-angle on the first postoperative day are independent predictors of DVT. MPV in patients with thrombosis tends to rise and then fall in the perioperative period. The optimal threshold for MPV to predict thrombosis is 10.85 fL and the area under the ROC curve is 0.694, The area under the ROC curve increases to 0.815 using MPV combined with alpha-angle. In addition, MA, α-angle, composite coagulation index (CI) and MPV were all statistically higher in the DVT group than in the control group (p  < 0.001). CONCLUSION: MPV is a predictor of DVT after TKA. It can reflect the hypercoagulable state of blood after surgery; Combination of MPV and alpha-angle on the first day after surgery in patients with TKA improves predictive power of DVT. Show more

Keywords: Thromboelastography, total knee arthroplasty, mean platelet volume, deep vein thrombosis

DOI: 10.3233/CH-231802

Citation: Clinical Hemorheology and Microcirculation, vol. 84, no. 3, pp. 321-331, 2023

Authors: Watson, Oliver | Zaldua, Jun-Cezar | Pillai, Suresh | Whitley, Janet | Howard, Matthew | Lawrence, Matthew | Hawkins, Karl | Morris, Keith | Evans, Phillip Adrian

Article Type: Research Article

Abstract: BACKGROUND: A significant degree of mortality and morbidity in COVID-19 is through thromboembolic complications, only partially mitigated by anticoagulant therapy. Reliable markers of infection severity are not fully established. OBJECTIVES: This study investigated whether visco-elastic biomarkers predict disease severity on presentation to the Emergency Department (ED) and how they measure response to anticoagulation METHODS: Patients testing positive for COVID-19 at a large University Teaching Hospital ED were recruited at presentation. Multiple blood samples were taken throughout hospital admission to monitor disease progression with end outcome recorded. Visco-elastic markers, fractal dimension (d f ) and Time …to Gel Point (TGP) which measure the properties of the incipient clot were compared in patients with and without anticoagulation by Low Molecular Weight Heparin (LMWH). RESULTS: TGP and d f did not predict severity of infection with COVID-19. Although LMWH prolonged TGP, there was no change in d f indicating LMWH did not change clot microstructure. CONCLUSIONS: Therapeutic efficacy of LMWH appears blunted in COVID-19 infection. This may be due to the inflammatory state creating a resistance to LMWH activity, which may explain why LMWH appears less effective in COVID-19 compared to other disease states. COVID-19 was not predicted by visco-elastic testing at the time of ED presentation. Show more

Keywords: COVID-19, coagulopathy, visco-elastic testing, anticoagulation, heparin resistance

DOI: 10.3233/CH-221635

Citation: Clinical Hemorheology and Microcirculation, vol. 84, no. 3, pp. 333-344, 2023