Intravitreal fibrin clots were produced by intravitreal injection of 0.2 ml autologous plasma in 18 rabbit eyes. Subsequently these eyes were treated by intravitreal injection of either tissue plasminogin activator(t-PA) or saline. In the t-PA(12.5mu;g) group(n=10),intravitreal fibrin clots of 6 eyes cleared up within 6 hours, and that of the other 4 eyes within 1 day. In the saline group( n=7), the complete clearallce was not seen after 7 days. The difference of time between two groups was significant ( P＜0. 05), and no evidence of toxic effect was observed as measured by slit-lamp biomicrocopy, ERG, light microcopy and transmission electron microscopy.One eye treated with 100mu;g t-PA also resulted in a total clearance within 6 hours,but retinal toxicity was demonstrated with ophthalmoscopy and light microscopy. （Chin J Ocul Fundus Dis,1994,10:14-16）
Abstract: Objective To investigate the messenger ribonucleic acid (mRNA) expression level of tissue-type plasminogen activator (t-PA) in endothelial cells derived from adult mesenchymal stem cells (MSCs) after fluid shear stress loading which is within the physiological range. Methods After culturing in vitro, bone marrow MSCs of SD rats were seeded on slides.When it come to 80% confluence,26 slides were exposed to 5dyn/cm2 fluid shear stress for 3h in a flow chamber, and then induced to endothelial cells. Among them,13 slides constituted group Ⅰ, and the rest 13 slides set up group Ⅱ, which would be cultured for 3-4d further and passaged in 1∶3. At the same time, control group was set up, which including the cells never exposed to fluid shear stress before the endothelial differentiation. Fluid shear stress were exerting to cells in a specially made flow chamber. The expression level of t-PA mRNA of all groups were measured by real-time fluorescent quantitation reverse transcriptionpolymerase chain reaction (RTPCR). Results After endothelial differentiation for 7 days, the SD rats bone marrow MSCs acquired typical endothelial cell appearance. The t-PA mRNA expression level of group Ⅰ and group Ⅱ have an obviously enhance compared with control group(P＜0.05). The t-PA mRNA expression level of group Ⅱ step down a little (P＞0.05), but it is still significantly higher than that of control group (P＜0.05). Conclusion Fluid shear stress could provide a protective action on the endothelial cells induced from MSCs in vitro, and the effect maintains with the cells passages. This formulates a theoretical foundation to the therapeutics of atherosclerosis and selection of seed cells in vascular tissue engineering.
ObjectiveTo explore the clinical value of the soluble urokinase type plasminogen activator receptor (suPAR) level in bronchoalveolar lavage fluid (BALF) for evaluateting the disease severity and prognosis of severe community-acquired pneumonia (SCAP). MethodsEighty-four patients with SCAP were recruited as a SCAP group from the respiratory department, ICU and RICU between April 2014 and April 2016. According to their organ dysfunction, the SCAP patients were subdivided into a MODS group and a non-MODS group. Depending on the treatment response on the 7th day of treatment, they were subdivided into an effective group and an ineffective group. According to the survival condition within 28 days, they were subdivided into a survival group and a death group. Meanwhile, 50 cases with non-severe common community acquired pneumonia were recruited as a control group. On the admission day, all cases were evaluated by PSI score and APACHE Ⅱscore. The serum suPAR level were detected by ELISA on the 1st day in hospital. The suPAR and procalcitonin (PCT) levels in the patient's BALF and serum were detected on the 1st, 3rd, 7th day, discharge or death day. The symptoms and signs, biochemical and pulmonary imaging changes were also observed. ResultsThere were no differences in the sex, age, body weight, duration of pneumonia, or complicated diseases such as hypertension, coronary heart disease and cerebral vascular diseases between the SCAP group and the control group (all P > 0.05). The suPAR levels in serum and BALF of the SCAP group were higher than those of the control group with significant differences (all P < 0.05). The suPAR level in BALF was obviously higher than that in serum in the SCAP group with significant difference (P < 0.05), and slightly higher than that in serum in the control group with no significant difference (P > 0.05). The level of suPAR in BALF of the MODS group was significantly higher than that in the non-MODS group with significant difference (P < 0.05), but there was no significant difference in the PCT level between the two groups (P > 0.05). The suPAR level in the ineffective treatment group was significantly higher than that in the effective treatment group on the 7th day in hospital with significant difference (P < 0.05). The suPAR levels in BALF of the death group were higher than those in the survival group at each time point after admittion with significant difference (all P < 0.05), and the PCT levels had no significant difference between the two groups within 1 week of each time point (all P > 0.05). The suPAR level in BALF of the SCAP group was positively correlated with APACHEⅡ score and PSI score (r=0.578, P=0.0085; r=0.565, P=0.0071), and plasma PCT level was weakly correlated with the APACHEⅡ score and PSI score (r1=-0.0137, r2=-0.0152). ConclusionThe SuPAR level in BALF of patients with SCAP is closely related to the severity and prognosis, and can be used as an index to assess the severity and prognosis.
ObjectiveTo evaluate the therapeutic effects of super-selective arterial catheterization with thrombolysis for central retinal artery occlusion (CRAO).MethodsThe clinical data of 16 patients with CRAO were collected. Aortic arch angiography with the catheterization through femoral artery firstly, and then the selective internal carotid artery angiography had been performed on all of the patients, including 12 ones who had undergone the urokinase thrombolysis therapy.ResultsIn the 16 patients, 3 with the severe straitness of the internal carotid artery and 1 with occlusion of incision of the ocular artery had not been treated by thrombolysis; and the others with occlusion of arterial trunk and CRAO had undergone thrombolysis therapy successfully. After the treatment, the visual acuity of the patients had improved in different degree and no systemic side effect had been found during the treatment.ConclusionsSuper-selective arterial catheterization with thrombolysis for CRAO may improve the visual acuity of the patients. The effects and risks of this treatment should be evaluated in further study.(Chin J Ocul Fundus Dis, 2005,21:20-21)
Objective To assess the effect of different thrombolytic agents, and different regimens in acute ischaemic stroke. Methods A systematic review of all the relevant randomized controlled trials (RCTs) was performed. RCTs were identified from the Cochrane Stroke Group trials register, Embase (1980 to 1997), handsearching Japanese and Chinese journals, and personal contact with pharmaceutical companies. We included randomised and quasi-randomised trials in patients with confirmed acute ischaemic stroke comparing different doses of a thrombolytic agent, or different thrombolytic agent, or the same agent given by different routes. Results Eight trials involving 1 334 patients were included. Concealment of allocation was generally adequate. All the trials were conducted in Japan. Different doses (of tissue plasminogen activator or urokinase) were compared in six trials. Different agents (tissue plasminogen activator versus urokinase,or tissue-cultured urokinase versus conventional urokinase) were compared in three trials. Few data were available for functional outcomes. A higher dose of thrombolytic therapy was associated with a five-fold increase in fatal intracranial haernorrhages (odds ratio 5.02, 95% confidence interval 1.56 to 16.18). There was a non-significant trend towards more early deaths or clinically significant intracranial haemorrhages in higher dose group. No difference in late deaths or extra-cranial haemorrhages was shown between low and higher doses. However, very few of these events occurred. No difference was shown between the different thrombolytic agents tested. Conclusions There is not enough evidence to conclude whether lower doses of thrombolytic agents might be safer or more effective than higher doses in acute ischaemic stroke. It is not possible to conclude whether one agent might be better than another, or which route of administration might be best.
【Abstract】ObjectiveTo investigate the relationship between the expression of urokinase-type plasminogen activator (uPA) mRNA and breast cancer, lymph node metastasis. MethodsSixty patients with breast tumor were selected randomly and the expression of uPA mRNA was detected with RT-PCR. The patients were divided into benign group (18 cases) and malignant group (42 cases) which included 22 cases with lymph node metastasis and 20 cases without lymph node metastasis. The relationship between uPA mRNA expression and breast cancer, lymph node metastasis was analyzed. ResultsAmong these 18 benign tumors, low expression of uPA mRNA was found in 2 cases and the others were negative. While in 42 cases of malignant tumor, uPA mRNA were positive in 22 cases of lymph node metastasis, 16 of which were high expression, 5 of which were moderate expression, and 1 was low expression. uPA mRNA were positive in 18 of 20 cases of nonmetastatic lymph node, 1 of which was high expression, 5 of which were moderate expression and 12 of which were low expression, the other 2 were negative expression. The expression of uPA mRNA had significant difference between benign and malignant tumors (P＜0.05). The expression in lymph node metastasis was much higher than no lymph node metastasis (P＜0.05). ConclusionThe expression of uPA mRNA in malignant breast cancer is obviously higher than that in benign breast tumor. The expression tensity of uPA is highly relevant to lymph node metastasis in malignant breast cancer, which can provide evidence for clinical staging and therapy.
Objective To explore the effect of xue-shuan-tong(panax notoginsang saponins,PNS)or isovalaemic haemodilution(IHD)and PNS combining IHD treatment on activities of fibrinolysis and hemorrheology in patients with retinal vein occlusion (RVO). Methods Seventy-three patients with RVO were allocated at random to 3 groups which were treated with PNS,IHD and PNS combining IHD.The activities of t-PA and PAI,rheological parameters and visual acuity before and after treatment were observed. Results At the end of treatment,significantly increased activity of t-PA and decrease of PAI was found in combined treatment group and PNS group,but the difference before and after treatment was not significant in IHD group.Furthermore,except the plasma viscosity in IHD group,the other hemorrheological parameters in all the petients of 3 groups revealed to be improving.One month after treatment,the parameters return completely to normal in both PNS and IHD groups; while the whole blood apparent relative viscosity in low shear rate,RBC aggregation and RBC deformability maintained still in lower level,and also the visual acuity resumed better and quicker in combined group. Conclusion Combined treatment of PNS and IHD can both regulate the activity of fibrinolysis and decrease the blood viscosity of patients with RVO for a period of relatively long time and increase the effect of treatment. (Chin J Ocul Fundus Dis,1998,14:7-9)
ObjectivesTo systematically review the efficacy and safety of plasminogen activator assist external ventricular drainage in cerebral hemorrhage.MethodsPubMed, EMbase, The Cochrane Library, CNKI, VIP, CBM and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy and safety of plasminogen activator assist external ventricular drainage in cerebral hemorrhage from inception to March 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 23 RCTs involving 1 560 patients were included. The results of meta-analysis showed that, compared with the blank control or placebo, the addition of plasminogen activator urokinase after puncture and drainage could improve the clinical efficacy (RR=1.36, 95%CI 1.26 to 1.47, P<0.000 01), shorten removal time of hematoma (MD=−3.37, 95%CI −3.89 to −2.85, P<0.000 01), reduce postoperative re-bleeding rate (Peto OR=0.30, 95%CI 0.18 to 0.51, P<0.000 01), reduce the incidence of intracranial infection (Peto OR=0.47, 95%CI 0.25 to 0.87, P=0.02), and reduce mortality (Peto OR=0.45, 95%CI 0.27 to 0.76, P=0.003). The differences were statistically significant between two groups.ConclusionsCurrent evidence shows that the combination with urokinase can improve curative effect of hypertension cerebral hemorrhage patients with external ventricular drainage. In reducing hemorrhage, intracranial infection and mortality, urokinase also has great curative effect. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
Objective Investigate the effect and treatment prospects of urokinase-type plasminogen activator receptor（uPAR）in human epidermal growth factor receptor-2 （HER-2） positive breast cancer. Method Aricals related effect of uPAR in HER-2 positive breast caner were retrieved through Pubmed， and the role of uPAR was reviewed. Results uPAR played a very important role in the HER-2 positive breast cancer， anti-uPAR monomer or uPAR binding inhibitors could inhibit the growth， invasion and metastasis of breast cancer cells. Conclusion uPAR is one of the effective target for breast cancer， and it provides a new breakthrough in the treatment of HER-2 positive breast cancer.
【Abstract】Objective To explore the differential diagnostic value of major fibrinolytic parameters in pleural fluid. Methods Tissue-type plasminogen activator( t-PA) and plasminogen activator inhibitor-1( PAI-1) in pleural fluid at the first thoracentesis were measured with ELISA and D-dimer was measured with immunoturbidimetry. Results Eighty-four patients with pleural effusion were enrolled, among which 40 with malignant effusion, 33 with infectious effusion and 11 with transudative effusion. t-PA level was higher in malignant and transudative pleural fluid than that in infectious pleural fluid[ ( 52. 49 ±31. 46) ng /mL and ( 58. 12 ±23. 14) ng /mL vs ( 37. 39 ±22. 44) ng /mL, P lt; 0. 05] , but was not statistically different between malignant pleural fluid and transudative ( P gt; 0. 05) . PAI-1 level was higher in malignant and infectious pleural fluid than that in transudative [ ( 164. 86 ±150. 22) ng/mL and ( 232. 42 ±175. 77) ng/mL vs ( 46. 38 ±16. 13) ng/mL, P lt; 0. 01] , but was not statistically different between malignant and infectious pleural fluid( P gt;0. 05) . D-dimer levels in the three types of pleural fluid were significantly different, which was ( 23. 66 ±25. 18) mg/L, ( 6. 36 ±10. 87) mg/L and ( 66. 90 ±42. 17) mg/L in malignant, transudative and infectious pleural fluid, respectively. As single-item detection for malignant pleural fluid, the cutoff of t-PA was gt; 38. 7 ng/mL( area under ROC curve was 64. 0 ) , with sensitivity of 60. 0% , specificity of 63. 6%, positive predictive value of 66. 7%, negative predictive value of 56. 8% and accuracy of 61. 6% .The cutoff of D-dimer was lt; 27. 0 mg/L( area under ROC curve was 85. 5) , with sensitivity of 84. 8% ,specificity of 72. 5% , positive predictive value of 85. 3% , negative predictive value of 71. 8% and accuracy of78.1%. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of combined examination( t-PA + D-dimer) were 92. 5% , 60. 6% , 74. 0% , 87. 0% , 78. 1% , respectively.Conclusions The t-PA, PAI-1 and D-dimer levels are significantly different in the three types of pleural fluid. The detection of fibrinolytic parameters in pleural fluid, especially the value of D-dimer,may be helpful in the differential diagnosis of pleural effusion.