Objective： To explore the relationship between disseminated intravascular coagulation （DIC） and levels of plasma thrombinogen segment 1 ＋2 （Fl＋2）, D-dimer （D-D）, and thrombomodulin （TM） in patients with sev...Objective： To explore the relationship between disseminated intravascular coagulation （DIC） and levels of plasma thrombinogen segment 1 ＋2 （Fl＋2）, D-dimer （D-D）, and thrombomodulin （TM） in patients with severe multiple injuries. Methods： In this study, 66 patients （49 males and 17 females, aged 15-74 years, mean=38.4 years） with multiple injuries, who were admitted to our hospital within 24 hours after injury with no personal or family history ofhematopathy or coagulopathy, were divided into a minor injury group （ISS 〈16, n=21） and a major injury group （ISS≥16, n=45） according to the injury severity. The patients in the major injury group were divided into a subgroup complicated with DIC （DIC subgroup, n=12） and a subgroup complicated with no DIC （non-DIC subgroup, n=33）. Ten healthy people （7 males and 3 females, aged 22-61 years, mean=36.5 years±9.0 years）, who received somatoscopy and diagnosed as healthy, served as the control group. Venous blood samples were collected once in the control group and 1, 3 and 7 days after trauma in the injury groups. The F1 ＋2 and TM concentrations were determined by enzyme linked immunosorbent assay （ELISA）, and D-D concentrations were measured by automated latex enhanced immunoassay. Results： FI ＋2, D-D and TM levels were higher in the minor and major injury groups than in the control group. They were markedly higher in the major injury group than in the minor injury group. In the non-DIC subgroup, Fl＋2 levels declined gradually while D-D and TM levels declined continuously. In the DIC subgroup, F1＋2 and D-D levels remained elevated while TM levels exhibited an early rise and subsequent decrease. Plasma F1＋2, D-D and TM levels were higher in the DIC patients than in the non-DIC patients. Injury-induced increases in F1 ＋2, D-D and TM plasma levels had significant positive correlation with each other at each time point. Conclusions： Besides being related to trauma severity, F1＋2, D-D and TM levels cor展开更多
Objective To review the update research progress about the treatment of diabetic macular edema and to give helpful guidelines in the treatment of diabetic macular edema based on available evidence to date. Data source...Objective To review the update research progress about the treatment of diabetic macular edema and to give helpful guidelines in the treatment of diabetic macular edema based on available evidence to date. Data sources A literature search of all English articles was performed on the online electronic PubMed database dated 1984 to 2009. The keywords searched included： macular edema, therapy, laser coagulation, intravitreal triamcinolone acetonide, vascular endothelial growth factor inhibitor, protein kinase C inhibitor and Pars plana vitrectomy. After finding relevant articles within these search limits, a manual search was conducted through the references from these articles. Study selection Original articles and critical reviews were reviewed and selected to address the stated purpose. Results To date, demonstrated means to reduce the risk of vision loss from diabetic macular edema include focal/grid laser photocoagulation and improved metabolic control. Emerging pharmacologic therapies （intravitreal triamcinolone acetonide, vascular endothelial growth factor inhibitors and protein kinase C beta-isoform inhibitors） and Pars plana vitrectomy have shown early promise in the treatment of diabetic macular edema. Conclusions As there has been extensive development in multiple treatments of diabetic macular edema, choice of the most suitable treatment for specific patients becomes important. Combination therapy of laser, pharmacological and surqical treatment modalities mav offer an alternative to treatment of diabetic macular edema.展开更多
To evaluate long-term endoscopic resolution and recurrence rate of gastric antral vascular ectasia (GAVE) after argon plasma coagulation (APC) treatment. METHODSThis was an IRB-approved retrospective single center stu...To evaluate long-term endoscopic resolution and recurrence rate of gastric antral vascular ectasia (GAVE) after argon plasma coagulation (APC) treatment. METHODSThis was an IRB-approved retrospective single center study that included patients endoscopically treated for GAVE between 1/1/2008 to 12/31/2014. The primary and secondary end points of the study were rate of endoscopic resolution of GAVE after APC treatment and recurrence rate of GAVE after endoscopic resolution, respectively. Endoscopic resolution of GAVE was defined as no endoscopic evidence of GAVE after treatment with APC. Recurrence of GAVE was defined as endoscopic reappearance of GAVE after prior resolution. RESULTSTwenty patients met the study criteria. Median age (range) of the patients was 59.5 years (42-74 years). GAVE was associated with underlying cirrhosis in 16 (80%) patients. Indications for initial esophagogastroduodenoscopy (EGD) included hematemesis and/or melena (9/20, 45%), iron deficiency anemia (6/20, 30%), screening or surveillance of varices (4/20, 20%), and occult gastrointestinal bleeding (1/20, 5%). The patients were treated with a total of 55 APC sessions (range 1-7 sessions). Successful endoscopic resolution of GAVE was achieved in 8 out of 20 patients (40%). There was no correlation between number of treatment sessions and GAVE treatment success (P = NS). Recurrence of GAVE was noted on a subsequent EGD in 2 out of 8 patients (25%) with prior endoscopic resolution of GAVE. Median follow-up period for the study population was 627 d (range 63-1953 d). CONCLUSIONEndoscopic resolution rate of GAVE was low (40%) with a 25% recurrence rate after treatment with APC. These rates suggest that APC treatment of GAVE may not be optimal in many circumstances.展开更多
目的观察不同海拔地区脓毒性休克患者早期舌下微循环的变化情况,为临床治疗高海拔地区脓毒性休克患者提供参考。方法选取2021年9月至2023年3月在青海省人民医院和武汉大学中南医院重症医学科,收治的高海拔地区(西宁)28例和低海拔地区(武...目的观察不同海拔地区脓毒性休克患者早期舌下微循环的变化情况,为临床治疗高海拔地区脓毒性休克患者提供参考。方法选取2021年9月至2023年3月在青海省人民医院和武汉大学中南医院重症医学科,收治的高海拔地区(西宁)28例和低海拔地区(武汉)26例脓毒性休克患者作为研究对象,记录患者基础资料、血细胞计数、炎症指标、凝血功能指标[凝血酶原时间(PT)、凝血酶时间(TT)、国际标准化比值(INR)],应用旁流暗视野成像(SDF)监测技术监测舌下微循环指标[总血管密度(TVD)、灌注血管密度(PVD)、灌注血管比例(PPV)、微血管流动指数(MFI)、异质性指数(HI)]。比较不同海拔地区患者舌下微循环的变化。结果两地区脓毒性休克患者基础资料、炎症指标及INR比较差异无统计学意义(P>0.05);高海拔地区脓毒性休克患者PT[19.65(16.80,31.50)s vs 14.60(12.92,18.65)s]、TT[20.45(18.78,23.18)s vs 15.65(13.82,19.55)s]较低海拔患者延长(P<0.05)。与低海拔患者相比,高海拔脓毒性休克患者TVD[17.37(13.61,19.65)mm/mm^(2) vs 14.18(13.10,16.07)mm/mm^(2)]、HI[1.60(0.55,3.00)vs 0.71(0.44,1.05)]显著增加(P<0.05);而PVD[3.29(1.83,11.24)mm/mm^(2) vs 12.66(9.39,14.87)mm/mm^(2)]、PPV[22.55%(10.28%,77.15%)vs 87.85%(72.02%,94.65%)]、MFI[0.87(0.63,1.95)vs 2.50(2.24,2.71)]显著降低(P<0.05)。结论高海拔地区脓毒性休克患者舌下微循环障碍较低海拔患者更为明显,其中PVD、PPV、MFI明显减少,HI更为突出。展开更多
Gastric antral vascular ectasia (GAVE) is an uncommon and often neglected cause of gastric hemorrhage. The treatments for GAVE include surgery, endoscopy and medical therapies. Here, we report an unusual case of GAVE....Gastric antral vascular ectasia (GAVE) is an uncommon and often neglected cause of gastric hemorrhage. The treatments for GAVE include surgery, endoscopy and medical therapies. Here, we report an unusual case of GAVE. A 72-year-old man with a three-month history of recurrent melena was diagnosed with GAVE. Endoscopy revealed the classical “watermelon stomach” appearance of GAVE and complete pyloric involvement. Melena reoccurred three days after argon plasma coagulation treatment, and the level of hemoglobin dropped to 47 g/L. The patient was then successfully treated with distal gastrectomy with Billroth II anastomosis. We propose that surgery should be considered as an effective option for GAVE patients with extensive and severe lesions upon deterioration of general conditions and hemodynamic instability.展开更多
Objective:To observe the effect of Taohong Siyu Decoction on the coagulation function and the signaling pathway of PI3K(phosphatidylinositol 3-kinase)/AKT(protein kinase B)/mTOR(mammalian target of rapamycin)after fem...Objective:To observe the effect of Taohong Siyu Decoction on the coagulation function and the signaling pathway of PI3K(phosphatidylinositol 3-kinase)/AKT(protein kinase B)/mTOR(mammalian target of rapamycin)after femoral artery anastomosis in rabbits.Methods:30 New Zealand white rabbits were divided into blank control group,model control group,papavine hydrochloride injection group and low,medium and high dose groups of Taohong Siwu decoction by random number table method,with 5 rabbits in each group.The rabbits in the model control group,papavine hydrochloride injection group and low,medium and high dose groups of Taohong Siwu decoction were treated with the femoral artery simple intermittent end-to-end suture model.After the successful modeling,the low,medium and high dose groups of Taohong Siwu decoction were given the Taohong Siwu decoction,while the model control group,the blank control group and papavine hydrochloride injection group were given the same amount of normal saline.APTT(activated partial thromboplastin time),FIB(fibrinogen)and PI3K/AKT/mTOR concentrations were measured in aural venous blood samples from six groups of rabbits 30min before operation and 1d,2D,3D and 7d after operation,respectively.Statistical analysis was conducted on the data of the six groups.Results:Compared with blank control group,APTT of model control group was significantly shortened 1d to 7d after operation(P<0.05),FIB values were significantly increased from 1d to 7d after operation(P<0.05);Compared with model control group,APTT in Taohong Siwu decoction low-dose,medium-dose and high-dose groups were significantly prolonged 1d to 7d after operation(P<0.05),FIB value of Taohong Siwu decoction medium and high dose groups decreased significantly from 1d to 7d after operation(P<0.05),the FIB value of Taohong Siwu decoction low-dose group was significantly decreased from 2d to 7d after surgery(P<0.05);Compared with papaverine hydrochloride injection group,APTT in Taohong Siwu decoction medium dose group was significantly prol展开更多
BACKGROUND Gastric antral vascular ectasia(GAVE)has diverse associations and presumed causes,which include liver cirrhosis,chronic kidney disease,and autoimmune disease.This heterogeneity of underlying disorders sugge...BACKGROUND Gastric antral vascular ectasia(GAVE)has diverse associations and presumed causes,which include liver cirrhosis,chronic kidney disease,and autoimmune disease.This heterogeneity of underlying disorders suggests that the pathogenesis of GAVE may be variable.AIM To compare the clinical features and long-term outcomes of GAVE according to endoscopic patterns and etiologies.METHODS The medical records and endoscopic images of 23 consecutive patients diagnosed with GAVE by endoscopy at Yeungnam University Hospital from January 2006 to December 2020 were retrospectively reviewed.Patients were allocated to cirrhosis(16 patients)and non-cirrhosis groups(7 patients).GAVE subtypes,as determined by endoscopy,were categorized as punctate(a diffuse,honeycomb-like appearance,17 patients)or striped(a linear,watermelon-like appearance,6 patients).RESULTS All GAVE patients with cirrhosis(16/16,100%)had a punctate pattern by endoscopy,whereas the majority of patients(6/7,85.7%)without cirrhosis had a striped pattern(P<0.001).Overt GAVE bleeding(10/23,43%)was significantly more common in the non-cirrhosis group than in the cirrhosis group(6/7,85.7%vs 4/16,25.0%;P=0.019),and more common in the striped group than in the punctate group(5/6,83.3%vs 5/17,29.4%;P=0.052).However,mean numbers of admissions due to GAVE bleeding and argon plasma coagulation(APC)sessions to address overt bleeding were similar in the cirrhosis and non-cirrhosis groups and in the punctate and striped groups.All patients with GAVE bleeding were successfully treated by APC,and no patient died from GAVE-related blood loss during a median follow-up of 24 mo.CONCLUSION Punctate-type GAVE is strongly associated with liver cirrhosis,and GAVE patients without cirrhosis tend to be more prone to overt bleeding.However,the presence of cirrhosis and endoscopic patterns did not influence long-term clinical courses or outcomes in cases of overt bleeding.展开更多
Tumor vascular infarction has been regarded as a promising therapy in tumor treatment.However,due to the limited activity of designed coagulation agents,resulting from the challenges of inducing sustained and complete...Tumor vascular infarction has been regarded as a promising therapy in tumor treatment.However,due to the limited activity of designed coagulation agents,resulting from the challenges of inducing sustained and complete thrombosis and associated selectivity issues,the traditional vascular infarction strategy consequently results in treatment failure.Here,we report a photo-initiated coagulation activation and fibrinolysis inhibition approach to achieve synergetic tumor vascular infarction via gold nanorods(AuNRs)-based nanosystem for the co-delivery of coagulation initiator thrombin and fibrinolysis inhibitor tranexamic acid.With a photo-initiated cascade reaction,thrombin and tranexamic acid could be released from the nanosystem to activate coagulation and inhibit the fibrinolysis within tumor vessels.By integrating these two physiological reactions,fortified clots were formed,and tumor vessels were occluded steadily,affecting the metabolism of the tumor cells,thereby inhibiting tumor growth.This strategy might open an alternative path for the advancement of the current tumor vascular infarction strategy.展开更多
文摘Objective： To explore the relationship between disseminated intravascular coagulation （DIC） and levels of plasma thrombinogen segment 1 ＋2 （Fl＋2）, D-dimer （D-D）, and thrombomodulin （TM） in patients with severe multiple injuries. Methods： In this study, 66 patients （49 males and 17 females, aged 15-74 years, mean=38.4 years） with multiple injuries, who were admitted to our hospital within 24 hours after injury with no personal or family history ofhematopathy or coagulopathy, were divided into a minor injury group （ISS 〈16, n=21） and a major injury group （ISS≥16, n=45） according to the injury severity. The patients in the major injury group were divided into a subgroup complicated with DIC （DIC subgroup, n=12） and a subgroup complicated with no DIC （non-DIC subgroup, n=33）. Ten healthy people （7 males and 3 females, aged 22-61 years, mean=36.5 years±9.0 years）, who received somatoscopy and diagnosed as healthy, served as the control group. Venous blood samples were collected once in the control group and 1, 3 and 7 days after trauma in the injury groups. The F1 ＋2 and TM concentrations were determined by enzyme linked immunosorbent assay （ELISA）, and D-D concentrations were measured by automated latex enhanced immunoassay. Results： FI ＋2, D-D and TM levels were higher in the minor and major injury groups than in the control group. They were markedly higher in the major injury group than in the minor injury group. In the non-DIC subgroup, Fl＋2 levels declined gradually while D-D and TM levels declined continuously. In the DIC subgroup, F1＋2 and D-D levels remained elevated while TM levels exhibited an early rise and subsequent decrease. Plasma F1＋2, D-D and TM levels were higher in the DIC patients than in the non-DIC patients. Injury-induced increases in F1 ＋2, D-D and TM plasma levels had significant positive correlation with each other at each time point. Conclusions： Besides being related to trauma severity, F1＋2, D-D and TM levels cor
文摘Objective To review the update research progress about the treatment of diabetic macular edema and to give helpful guidelines in the treatment of diabetic macular edema based on available evidence to date. Data sources A literature search of all English articles was performed on the online electronic PubMed database dated 1984 to 2009. The keywords searched included： macular edema, therapy, laser coagulation, intravitreal triamcinolone acetonide, vascular endothelial growth factor inhibitor, protein kinase C inhibitor and Pars plana vitrectomy. After finding relevant articles within these search limits, a manual search was conducted through the references from these articles. Study selection Original articles and critical reviews were reviewed and selected to address the stated purpose. Results To date, demonstrated means to reduce the risk of vision loss from diabetic macular edema include focal/grid laser photocoagulation and improved metabolic control. Emerging pharmacologic therapies （intravitreal triamcinolone acetonide, vascular endothelial growth factor inhibitors and protein kinase C beta-isoform inhibitors） and Pars plana vitrectomy have shown early promise in the treatment of diabetic macular edema. Conclusions As there has been extensive development in multiple treatments of diabetic macular edema, choice of the most suitable treatment for specific patients becomes important. Combination therapy of laser, pharmacological and surqical treatment modalities mav offer an alternative to treatment of diabetic macular edema.
文摘To evaluate long-term endoscopic resolution and recurrence rate of gastric antral vascular ectasia (GAVE) after argon plasma coagulation (APC) treatment. METHODSThis was an IRB-approved retrospective single center study that included patients endoscopically treated for GAVE between 1/1/2008 to 12/31/2014. The primary and secondary end points of the study were rate of endoscopic resolution of GAVE after APC treatment and recurrence rate of GAVE after endoscopic resolution, respectively. Endoscopic resolution of GAVE was defined as no endoscopic evidence of GAVE after treatment with APC. Recurrence of GAVE was defined as endoscopic reappearance of GAVE after prior resolution. RESULTSTwenty patients met the study criteria. Median age (range) of the patients was 59.5 years (42-74 years). GAVE was associated with underlying cirrhosis in 16 (80%) patients. Indications for initial esophagogastroduodenoscopy (EGD) included hematemesis and/or melena (9/20, 45%), iron deficiency anemia (6/20, 30%), screening or surveillance of varices (4/20, 20%), and occult gastrointestinal bleeding (1/20, 5%). The patients were treated with a total of 55 APC sessions (range 1-7 sessions). Successful endoscopic resolution of GAVE was achieved in 8 out of 20 patients (40%). There was no correlation between number of treatment sessions and GAVE treatment success (P = NS). Recurrence of GAVE was noted on a subsequent EGD in 2 out of 8 patients (25%) with prior endoscopic resolution of GAVE. Median follow-up period for the study population was 627 d (range 63-1953 d). CONCLUSIONEndoscopic resolution rate of GAVE was low (40%) with a 25% recurrence rate after treatment with APC. These rates suggest that APC treatment of GAVE may not be optimal in many circumstances.
文摘目的观察不同海拔地区脓毒性休克患者早期舌下微循环的变化情况,为临床治疗高海拔地区脓毒性休克患者提供参考。方法选取2021年9月至2023年3月在青海省人民医院和武汉大学中南医院重症医学科,收治的高海拔地区(西宁)28例和低海拔地区(武汉)26例脓毒性休克患者作为研究对象,记录患者基础资料、血细胞计数、炎症指标、凝血功能指标[凝血酶原时间(PT)、凝血酶时间(TT)、国际标准化比值(INR)],应用旁流暗视野成像(SDF)监测技术监测舌下微循环指标[总血管密度(TVD)、灌注血管密度(PVD)、灌注血管比例(PPV)、微血管流动指数(MFI)、异质性指数(HI)]。比较不同海拔地区患者舌下微循环的变化。结果两地区脓毒性休克患者基础资料、炎症指标及INR比较差异无统计学意义(P>0.05);高海拔地区脓毒性休克患者PT[19.65(16.80,31.50)s vs 14.60(12.92,18.65)s]、TT[20.45(18.78,23.18)s vs 15.65(13.82,19.55)s]较低海拔患者延长(P<0.05)。与低海拔患者相比,高海拔脓毒性休克患者TVD[17.37(13.61,19.65)mm/mm^(2) vs 14.18(13.10,16.07)mm/mm^(2)]、HI[1.60(0.55,3.00)vs 0.71(0.44,1.05)]显著增加(P<0.05);而PVD[3.29(1.83,11.24)mm/mm^(2) vs 12.66(9.39,14.87)mm/mm^(2)]、PPV[22.55%(10.28%,77.15%)vs 87.85%(72.02%,94.65%)]、MFI[0.87(0.63,1.95)vs 2.50(2.24,2.71)]显著降低(P<0.05)。结论高海拔地区脓毒性休克患者舌下微循环障碍较低海拔患者更为明显,其中PVD、PPV、MFI明显减少,HI更为突出。
文摘Gastric antral vascular ectasia (GAVE) is an uncommon and often neglected cause of gastric hemorrhage. The treatments for GAVE include surgery, endoscopy and medical therapies. Here, we report an unusual case of GAVE. A 72-year-old man with a three-month history of recurrent melena was diagnosed with GAVE. Endoscopy revealed the classical “watermelon stomach” appearance of GAVE and complete pyloric involvement. Melena reoccurred three days after argon plasma coagulation treatment, and the level of hemoglobin dropped to 47 g/L. The patient was then successfully treated with distal gastrectomy with Billroth II anastomosis. We propose that surgery should be considered as an effective option for GAVE patients with extensive and severe lesions upon deterioration of general conditions and hemodynamic instability.
文摘Objective:To observe the effect of Taohong Siyu Decoction on the coagulation function and the signaling pathway of PI3K(phosphatidylinositol 3-kinase)/AKT(protein kinase B)/mTOR(mammalian target of rapamycin)after femoral artery anastomosis in rabbits.Methods:30 New Zealand white rabbits were divided into blank control group,model control group,papavine hydrochloride injection group and low,medium and high dose groups of Taohong Siwu decoction by random number table method,with 5 rabbits in each group.The rabbits in the model control group,papavine hydrochloride injection group and low,medium and high dose groups of Taohong Siwu decoction were treated with the femoral artery simple intermittent end-to-end suture model.After the successful modeling,the low,medium and high dose groups of Taohong Siwu decoction were given the Taohong Siwu decoction,while the model control group,the blank control group and papavine hydrochloride injection group were given the same amount of normal saline.APTT(activated partial thromboplastin time),FIB(fibrinogen)and PI3K/AKT/mTOR concentrations were measured in aural venous blood samples from six groups of rabbits 30min before operation and 1d,2D,3D and 7d after operation,respectively.Statistical analysis was conducted on the data of the six groups.Results:Compared with blank control group,APTT of model control group was significantly shortened 1d to 7d after operation(P<0.05),FIB values were significantly increased from 1d to 7d after operation(P<0.05);Compared with model control group,APTT in Taohong Siwu decoction low-dose,medium-dose and high-dose groups were significantly prolonged 1d to 7d after operation(P<0.05),FIB value of Taohong Siwu decoction medium and high dose groups decreased significantly from 1d to 7d after operation(P<0.05),the FIB value of Taohong Siwu decoction low-dose group was significantly decreased from 2d to 7d after surgery(P<0.05);Compared with papaverine hydrochloride injection group,APTT in Taohong Siwu decoction medium dose group was significantly prol
基金Supported by the 2020 Yeungnam University Research Grant。
文摘BACKGROUND Gastric antral vascular ectasia(GAVE)has diverse associations and presumed causes,which include liver cirrhosis,chronic kidney disease,and autoimmune disease.This heterogeneity of underlying disorders suggests that the pathogenesis of GAVE may be variable.AIM To compare the clinical features and long-term outcomes of GAVE according to endoscopic patterns and etiologies.METHODS The medical records and endoscopic images of 23 consecutive patients diagnosed with GAVE by endoscopy at Yeungnam University Hospital from January 2006 to December 2020 were retrospectively reviewed.Patients were allocated to cirrhosis(16 patients)and non-cirrhosis groups(7 patients).GAVE subtypes,as determined by endoscopy,were categorized as punctate(a diffuse,honeycomb-like appearance,17 patients)or striped(a linear,watermelon-like appearance,6 patients).RESULTS All GAVE patients with cirrhosis(16/16,100%)had a punctate pattern by endoscopy,whereas the majority of patients(6/7,85.7%)without cirrhosis had a striped pattern(P<0.001).Overt GAVE bleeding(10/23,43%)was significantly more common in the non-cirrhosis group than in the cirrhosis group(6/7,85.7%vs 4/16,25.0%;P=0.019),and more common in the striped group than in the punctate group(5/6,83.3%vs 5/17,29.4%;P=0.052).However,mean numbers of admissions due to GAVE bleeding and argon plasma coagulation(APC)sessions to address overt bleeding were similar in the cirrhosis and non-cirrhosis groups and in the punctate and striped groups.All patients with GAVE bleeding were successfully treated by APC,and no patient died from GAVE-related blood loss during a median follow-up of 24 mo.CONCLUSION Punctate-type GAVE is strongly associated with liver cirrhosis,and GAVE patients without cirrhosis tend to be more prone to overt bleeding.However,the presence of cirrhosis and endoscopic patterns did not influence long-term clinical courses or outcomes in cases of overt bleeding.
基金supported by the National Natural Science Foundation of China(grant nos.51988102,51833007,51690152,51533006,and 21721005)the National Key Research and Development Program of China(grant no.2019YFA0905603).
文摘Tumor vascular infarction has been regarded as a promising therapy in tumor treatment.However,due to the limited activity of designed coagulation agents,resulting from the challenges of inducing sustained and complete thrombosis and associated selectivity issues,the traditional vascular infarction strategy consequently results in treatment failure.Here,we report a photo-initiated coagulation activation and fibrinolysis inhibition approach to achieve synergetic tumor vascular infarction via gold nanorods(AuNRs)-based nanosystem for the co-delivery of coagulation initiator thrombin and fibrinolysis inhibitor tranexamic acid.With a photo-initiated cascade reaction,thrombin and tranexamic acid could be released from the nanosystem to activate coagulation and inhibit the fibrinolysis within tumor vessels.By integrating these two physiological reactions,fortified clots were formed,and tumor vessels were occluded steadily,affecting the metabolism of the tumor cells,thereby inhibiting tumor growth.This strategy might open an alternative path for the advancement of the current tumor vascular infarction strategy.
