The Effect of Rigid Cells on Blood Viscosity: Linking Rheology and Sickle Cell Anemia

ickle cell anemia (SCA) is a disease that affects red blood cells (RBCs). Healthy RBCs are highly deformable objects that under flow can penetrate blood capillaries smaller than their typical...

Mathematical modeling of the hematocrit influence on cerebral blood flow in preterm infants

Premature birth is one of the most important factors increasing the risk for brain damage in newborns. Development of an intraventricular hemorrhage in the immature brain is often triggered by fluctuations of cerebral blood flow (CBF). Therefore, monitoring of CBF becomes an important task in clinical care of preterm infants. Mathematical modeling of CBF can be a complementary tool in addition to diagnostic tools in clinical practice and research. The purpose of the present study is an enhancement of the previously developed mathematical model for CBF by a detailed description of apparent blood viscosity and vessel resistance, accounting for inhomogeneous hematocrit distribution in multiscale blood vessel architectures. The enhanced model is applied to our medical database retrospectively collected from the 254 preterm infants with a gestational age of 23–30 weeks. It is shown that by including clinically measured hematocrit in the mathematical model, apparent blood viscosity, vessel resistance, and hence the CBF are strongly affected. Thus, a statistically significant decrease in hematocrit values observed in the group of preterm infants with intraventricular hemorrhage resulted in a statistically significant increase in calculated CBF values.

Efficacy and Safety of Shengmai Preparation Combined with Western Medicine for Coronary Heart Disease: A Systematic Review and Meta-Analysis

The efficacy and safety of Shengmai preparation combined with Western medicine (SMP–WM) to treat coronary heart disease (CHD) were reviewed. Twenty-five randomized controlled trials of SMP–WM treatment for CHD were retrieved from seven databases and other trial sources between their inception and April 10, 2021. The risk of bias domains was accessed by Cochrane Collaboration’s tool, and the data were statistically analyzed using RevMan 5.3 and Stata 12.0 software. The majority of included studies had a low or unclear risk of overall bias. Total mortality was not reduced (RR = 0.39, 95% CI: 0.13–1.19, [Formula: see text] = 0.10), but the cardiovascular events (RR = 0.35, 95% CI: 0.22–0.54, [Formula: see text] < 0.01), weekly frequency (SMD = −2.38, 95% CI: −2.89 – −1.88, [Formula: see text] < 0.01), and duration (SMD = −3.24, 95% CI: −3.76 – −2.71, [Formula: see text] < 0.01) of angina pectoris attacks were significantly decreased by SMP–WM. The SMP–WM combination exerted antiplatelet activity by reducing platelet adhesion (SMD = −0.97, 95% CI: −1.49 – −0.45, [Formula: see text] = 0.0003) and the platelet reactivity index (SMD = −1.75, 95% CI: −2.04 – −1.46, [Formula: see text] < 0.01). SMP–WM could protect endothelial function by increasing nitric oxide (SMD = 1.28, 95% CI: 0.54–2.02, [Formula: see text] < 0.01) and decreasing endothelin (SMD = −1.26, 95% CI: −1.85 – −0.66, [Formula: see text] < 0.01). The combination also improved hemorheology by reducing whole blood viscosity (SMD = −1.59, 95% CI: −2.32 – −0.85, [Formula: see text] < 0.01), plasma viscosity (SMD = −0.65, 95% CI: −0.86 – −0.45, [Formula: see text] < 0.01), and fibrinogen (SMD = −4.21, 95% CI: −4.58 – −3.83, [Formula: see text] < 0.01). The SMP–WM combination favorably impacts cardiovascular events, angina symptoms, endothelial function, platelet aggregation, and blood viscosity, with comparable safety to that of routine Western medicine. Further investigation is required to enhance the strength of the evidence.

Whole blood viscosity is associated with extrahepatic metastases and survival in patients with hepatocellular carcinoma

Whole blood viscosity (WBV) is increased in cancer patients and associated with the advanced stage with systemic metastases. However, relevance of WBV in hepatocellular carcinoma (HCC) remains unclear. This pilot study included a discovery cohort of 148 treatment-naïve HCC patients with preserved liver function, and a validation cohort of 33 treatment-experienced HCC patients with nivolumab. Systolic and diastolic WBV was measured using an automated scanning capillary tube viscometer at diagnosis or before the nivolumab treatment. Extrahepatic metastases were observed in 15 treatment-naïve patients (11.3%) at diagnosis. Portal vein tumor thrombosis (PVTT), tumor size, number of tumors, and systolic/diastolic WBV were factors associated with extrahepatic metastases. Systolic WBV and diastolic WBV were significantly increased in patients with metastases compared with patients without metastases. Multivariate logistic regression showed that high diastolic WBV > 16 cP was an independent factor associated with metastases. Notably, patients who developed extrahepatic metastases during the observation period among patients without metastases at diagnosis had higher diastolic WBV initially. Patients with high diastolic WBV had poor survival, and multivariate Cox regression analyses showed high diastolic WBV was an independent risk factor for poor survival with the Child-Pugh B7 and PVTT. High diastolic WBV also predicted poor survival in patients with low alpha-fetoprotein (AFP) and proteins induced by vitamin K antagonist-II (PIVKA-II) levels. In 33 nivolumab-treated patients, high diastolic WBV before the treatment was also tended to be associated with overall and progression-free survival. Our study is the first in which high WBV is associated with the distant metastases and survival in patients with HCC, but future prospective, large cohort studies are necessary to validate the results.