Purpose:To determine the efficacy of a low-molecular-weight heparin (fraxipparine) administered in the infusion fluid to prevent postoperative fibrin formation in a rabbit lensectomy and vitrectomy model. Methods:Fourteen adult pigmented rabbits were randomly as signed into two groups.Standard fragmatome lensectomies and core vitrectomies were performed prospectively in a masked fashion on control eyes with balanced salt infusion and on experimental eyes treated with fraxiparine/ml 6U in the infusate.Intraoperative bleeding was graded in a masked fashion by the surgeon. The amounts of firbrin and hemorrhage were graded in a masked fashion on postoperative days 1 through 7. Results:The mean grde of fibrin in the eyes treated with fraxiparine was lower than that in the control eyes (Plt;0.01) on postoperative days 1 through 3 respectively.Also,the average days to clear the fibrin in the eyes treated with fraxiparine was shorter than that in the control eyes (P＝0.001).No statistically significant differences in the degree of intraoperative or postoperative hemorrhage were noted between the two groups. Conclusion:Low-molecular weight heparin(fraxiparine) is an effetive inhibit or of postoperative fibrin formation in a rabbit model and is not associated with is not associated with an increased risk of intraoperative or postopertive bleeding at the tested dose. (Chin J Ocul Fundus Dis,1998,14:35-37)
Objective To make an individualized administration scheme via evidence-based medicine methods, namely adding heparin into the total nutrient admixture (TNA) solution, so as to help a neonate to prevent the occlusion of peripherally inserted central catheter (PICC). Methods After carefully assessing the condition of neonate, this clinical issue was put forward in accordance with the PICO principles. Randomized controlled trials (RCTs) and systematic reviews on neonates’ PICC occlusion were collected from The Cochrane Library, CCTR, DARE, NGC, MEDLINE (Ovid) and CBM from inception to 2011. The clinical intervention scheme was finally made after the assessment of the retrieved evidence and neonate’s physiological condition. Results A total of 4 RCTs and 1 systematic review related to the issues were identified. The following scheme was finally made for the neonate through the assessment of the retrieved evidence and combination of intentions of the patient’s family members: heparin (0.5 U/mL) was added into TNA to prevent PICC occlusion. During the application, blood routine test and blood coagulation were monitored, and the catheter opening time and extubation reason were recorded. Through the above treatment, the neonate successfully completed the treatment before extubation. The time of both PICC detaining and opening was 20 days in total, and there were no PICC occlusion, no catheter thrombosis, and no catheter related bloodstream infection. Moreover, no observation showed thrombopenia and aggravated coagulation disorders resulted from heparin. Conclusion The evidence-based medicine method is an effective way to make reasonable heparin scheme for neonate, so as to prevent PICC occlusion, reduce catheter thrombosis, decrease risks of catheter related blood circulation infection, assure successful completion of treatment, and guarantee the safety of patients.
Objective To evaluate the effects of peripheral venous remaining needle sealing with heparin vs. saline in China. Methods A comprehensive, systematic bibliographic search of medical literature from databases of CNKI (1994 to December, 2009) and Wanfang (1990 to December, 2009) was conducted to identify randomized controlled trials (RCTs) related to catheter sealing with saline vs. heparin. The remaining time of venous needle, the incidence of phlebitis and the catheter blockage were compared, and the quality of RCTs was assessed and meta-analyses were conducted by RevMan 5.0 software. Results Nine RCTs involving 1 770 patients were included. The results of meta-analyses showed that: a) There was a significant difference between heparin sealing and saline sealing in catheter blockage (OR=0.44, 95%CI 0.32 to 0.62, Plt;0.05). The heparin sealing was much better to prevent catheter blockage; b) There was no significant difference between saline sealing and heparin sealing in the incidence of phlebitis (OR=1.26, 95%CI 0.64 to 2.50, Pgt;0.05); and c) The average remaining time of venous catheter between saline sealing and heparin sealing had significant difference (WMD=0.24, 95%CI 0.04 to 0.43, Plt;0.05). Heparin sealing had better effect than saline sealing. Conclusion The meta-analyses of current medical literature in China show that heparin sealing can reduce the incidence of catheter blockage and prolong the remaining time of catheter, although there is no significant effect in the aspect of the incidence of phlebitis.
Objective To observe the therapeutic effects of vitrectomy combined with tissue plasminogen activator(r-tPA) and fraxiparine on bacterial endophthalmitis. Methods Forty pigmented rabbits were randomly divided into experimental and control group with 20 rabbits in each. The left eyes underwent intra-vitreous injection with 10 5/ml bacteria of staphylococcus epidermidis 0.1 ml. After 8-4 hours, vitrectomy was performed on all of the animals. Fraxiparine with the final concentration of 6 IU/ml was only added to balanced salt solution in the experimental group during the operation, and the extend of intraocular fibrin exudation was observed by slit lamp and indirect ophthalmoscope after the operation. If the exudation occurred on the 1st, 3rd, 7th, 14th and 21st day postoperatively, 125 mg/ml r-tPA 0.1 ml should be injected into vitreous from the 1st day after operation on. Results Fibrin exudation in the pupil area and vitreous body was much less in experimental group than that in the control group after the surgery. Conclusion vitrectomy combined with r-tPA and fraxiparine may alleviate the extent of fibrosis in bacterial endophthalmitis and improve the prognosis. (Chin J Ocul Fundus Dis, 2005, 21: 391-393)
Objective To observe the suppressive effect of co mbi nation of tissue plasminogen activator (t-PA), heparin and homoharringtonine on the formation of proliferative vitreoretinopathy (PVR) after vitreoretinal surgery. Methods Forty-three cases (44 eyes )of complicated retinal detachment who received vitreoretinal surgery were divided into 2 g roup s.Twenty cases(20 eyes)in group A were treated by intravitreal injection of abo ve mentioned drugs at the end of operation,while no intraocular injection of drugs given in 23cases(24 eyes)in group B.The mean follow-up period was 7.9 months. Result The rate of recurrent PVR in group A was 15.8%(3 of 19),and 45.5%(10 of 22) in group B (P＜0.05). The rate of recurrent retinal detachment was 5.5%(1 of 18) in group A,an d 33.3%(7 of 21) in group B，in group B(P＜0.05). Conclusion Combination use of the above mentioned drugs can effectively suppress the post operative recurrent PVR and lower the rate of subsequent recurrent retinal detac hment. (Chin J Ocul Fundus Dis, 2001,17:24-25)
ObjectiveTo evaluate the effect of heparin binding epidermal growth factor-like growth factor (HB-EGF) on liver regeneration after partial orthotopic liver transplantation. MethodsFourty SD rats were used to establish the model of partial orthotopic liver transplantation with ameliorated two-cuff technique. Then all the rats were divided into 2 groups: experiment group and control group. Twenty rats of experiment group were administered 500 μg/kg HBEGF via vena caudalis immediately after operation twice a day, while the same volume of saline was administered to the rats in control group. Five rats in each group were selected randomly and killed at the 6th hour, day 2, 4 and 7 after operation, respectively. The serum levels of albumin (Alb) and alanine aminotransferase (ALT) in the blood sample were detected. Every liver was removed and weighed. The expression of Ki67 was detected by using immunohistochemistry assay. The regeneration activity of hepatocytes was evaluated by flow cytometry. ResultsThe wet weights of liver in experiment group were all significantly higher than that in control group at the 6th hour, day 2 and 4 after transplantation (P＜0.05). The serum levels of ALT were significantly lower in experiment group than those in control group at the 6th hour, day 2， 4, 7 after operation (P＜0.05), while the levels of Alb were significantly higher on day 4 and 7. The proliferating index and Ki-67 labeling index of graft in experiment group were higher than those in control group on day 2 and 4 after transplantation （2 d: P＜0.01; 4 d: P＜0.05）. ConclusionHBEGF could promote the regeneration of rat hepatocytes after partial liver transplantation.
We cultured retinal g[ial cells(RGC)from immature rats and observed the migratory responses to fetal bovine serum(FBS).We found thai FItS stimulats the migration of RGC in a dose response manner. We also observed the inhibition of heparin on RGC cben,otaxis,and found that heparin(10U/ml)decreased significantly the RGC migration stimulated by serum(0%to 10%)(all Plt;0.0001).but 1U/ml of heparin bad no effect on RGC chemotaxis(P=0.5118).These results showed that FBS contains chemoattractants for RGC,and heparin can inhibit RGC chemotaxis stimulated by serum. （Chin J Ocul Fundus Dis,1994,10:170-173）
OBJECTIVE: To study the effect of therapeutic effect of heparin on wound healing of second-degree burned rats. METHODS: Deep second-degree burns with 20% of total body surface were made in 20 rats, which were randomly divided into 2 groups. The experimental group was treated subcutaneously injection with 1 ml of heparin 100 U/kg and saline solution, and the control group was treated with 1 ml of saline solution, once a day until complete healing of the burned wound. The healing time were compared, the growth of granulation tissue and collagen fibers were evaluated under light microscope, and the growth of fibroblasts were observed under electronic microscope. RESULTS: All rats survived, the healing time of experimental group (22.8 +/- 1.87 days) were much shorter than that of control group (26.2 +/- 2.82 days) (P lt; 0.005). Light microscope observation showed that the growth of granulation tissue and collagen fibers of experimental group were much better than that of control group, and electronic microscope also showed that the fibroblast growth was obviously better in the experimental group. CONCLUSION: Subcutaneous injection of heparin can promote wound healing.
Abstract： Objective To explore the feasibility of using protamine-agarose gel to achieve heparin-free cardiopulmonary bypass （CPB）. Methods A total of 12 healthy adult dogs were chosen, the dogs were between 2-3 years old,either male or female, with their mean body weight of 23.3±3.7 kg （ranging from 20 to 28 kg）. All the dogs were randomly divided into two groups with 6 dogs in each group. In the heparinized group, conventional CPB technique was used; in the non-heparinized group, protamine-agarose gel column was used to absorb plasma clotting factors in CPB without use of heparin. At the beginning of CPB and 1 h, 2 h, 3 h after CPB, arterial blood samples were collected from dogs in both groups. The expression levels of tumor necrosis factor-α （TNF-α）, interleukin-6 （IL-6） and interleukin-8 （IL-8） were measured by enzyme-linked immunosorbent assay（ELISA）and compared. Results There was no thrombus formation in the membrane oxygenators during CPB by naked eye observation in both groups. Activated coagulation time （ACT） was always greater than 480 s during CPB. The vital signs of the dogs were all stable during CPB. At the beginning of CPB, there was no statistical difference in plasma concentrations of TNF-α, IL-6, IL-8 between the two groups. At 1 h, 2 h and 3 h after CPB, the expression levels of TNF-α and IL-8 of the non-heparinized group were significantly higher than those of the heparinized group （CPB 3 h TNF-α：156.48±16.65 ng/L vs. 115.87±15.63 ng/L, t=4.356, P=0.001；CPB 3 h IL-8：365.38±46.18 ng/L vs. 299.29±34.50 ng/L, t=2.808, P=0.019）. There was no statistical difference in the expression level of IL-6 between the two groups （P＞0.05）. Conclusion Using protamine-agarose gel to absorb plasma clotting factors is an effective technique to establish heparin-free CPB. But this method can induce significant systemic inflammatory response.
Objective?To investigate the role of low-dose heparin added to total nutrient admixture (TNA) solutions in the prevention of catheter related infections (CRIs). Methods?One-hundred three newborn infants with periph-erally inserted central catheter (PICC) were divided into heparin group (n=63) and control group (n=40). The patients in the heparin group received TNA with 0.5 U/ ml heparin. The patients in the control group received TNA without heparin. We retrospectively analyzed the incidence of CRTs in the two groups. Results?We found that the incidence of CRIs was 0 in the heparin group and 12.5% (5/40) in the control group. The incidence of catheter obstruction was 6.3% (4/63) in the heparin group and 20% (8/40) in the control group. The incidence of catheter-tip colonization was 1.58% (1/40) in the heparin group and 17.5% (7/40) in the control group. The incidences of CRIs, catheter obstruction, and catheter-tip colonization were signiicantly lower in the heparin group than those in the control group (Plt;0.05). Conclusion?TNA solutions with 0.5U/ml heparin have decreased catheter obstruction and CRIs.