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Objective To investigate the effect of Tripterygium wilfordii polyglycosides(TWPS) on inflammatory response found in mouse models with Sjgren's syndrome(SS). Methods Mice were randomly divided into control group, Sjgren's syndrome model group, hydroxychloroquine sulfate treatment group (20 mg/kg hydroxychloroquine sulfate intragastric administration), TWPS low-dose, medium-dose and high-dose groups (10, 20, 30 mg/kg TWPS), TWPS + Wortmanin (PI3K/Akt/eNOS signaling pathway inhibitor) group (30 mg/kg TWPS and 0.6 mg/kg Wortmannin viajugular vein).Saliva flow rate, water intake, whole blood viscosity and plasma viscosity were recorded. Serum IL-6, IL-17, IgG and eNOS were detected by ELISA. Western blot was used to detect PI3K/Akt/eNOS pathway related proteins. Results Compared with control group, the saliva flow rate of the model group decreased and the quantity of drinking water increased(P＜0.05). Compared with model group, saliva flow rate increased and water consumption decreased in low, medium and high dose TWPS groups, which alleviated the change of model group(P＜0.05). Compared with the low, medium and high dose TWPS +Wortmanin groups, saliva flow rate decreased and water intake increased (P＜0.05). The whole blood and plasma viscosity of model group increased compared with control group(P＜0.05). The whole blood and plasma viscosity of TWPS low-dose, medium-dose and high-dose groups were lower than that of model group(P＜0.05). The whole blood and plasma viscosity of TWPS+Wortmanin group was higher than that of low, medium and high dose TWPS groups(P＜0.05). Compared with the control group, the levels of serum IL-6, IL-17 and IgG in model group were increased, while the level of eNOS was decreased(P＜0.05). The serum levels of IL-6, IL-17 and IgG in TWPS low-dose, medium-dose and high-dose groups were lower than those in model group, while the levels of eNOS were higher than those in model group(P＜0.05). The serum level of IL-6, IL-17 and IgG in TWPS +Wortmanin group increased as compared to those in low, medium and high dose TWPS +Wortmanin group, while the level of eNOS decreased as compared to those in low, medium and high dose TWPS +Wortmanin group(P＜0.05). The level of p-PI3K/PI3K, p-Akt/Akt and p-ENOS /eNOS in model group was lower than those in control group(P＜0.05). Compared with model group, p-PI3K/PI3K, p-Akt/Akt and p-ENOS/eNOS levels of TWPS in low, medium and high dose groups all increased(P＜0.05); The level of p-PI3K/PI3K, p-Akt/Akt and p-ENOS /eNOS in TWPS +Wortmanin group was lower than those in low, medium and high dose TWPS groups(P＜0.05). Conclusions TWPS alleviates inflammatory response and improves symptoms of mouse models with Sjgren's syndrome.

Background: The cessation of ovarian functions at menopause and the accompanying decline in the production of ovarian steroid hormones creates a unique set of health concerns for women. Reductions in sex steroid levels, particularly oestrogen, have been associated with various diseases and conditions, including bleeding disorders, coronary heart disease (CHD), osteoporosis, cognitive dysfunction, urinary incontinence, hot flushes, and mood changes, among others. Objective: To determine changes in haemorheological and clotting profile in post-menopausal women. Methods: Two hundred participants comprising one hundred and fifty post-menopausal women and fifty healthy pre-menopausal control subjects were studied. The investigations carried out include whole blood viscosity, plasma viscosity, fibrinogen concentration, Prothrombin time (PT), Activated partial thromboplastin time with kaolin (APTTK) levels and complete blood count using standard methods. Results: The mean age (p = 0.01), platelet count (p = 0.013), neutrophil (p = 0.03), neutrophil to lymphocyte ratio (p = 0.045) and platelet to lymphocyte ratio (p = 0.044) in postmenopausal women were significantly higher while lymphocyte count (p = 0.004) was significantly lower in postmenopausal compared to premenopausal women. Similarly, plasma oestradiol (p = 0.001), plasma viscosity (p = 0.03), relative blood viscosity (p = 0.03), whole blood viscosity (p = 0.03) and PTTK (p = 0.04) were significantly lower among postmenopausal women compared to premenopausal control subjects. Conclusion: Relative plasma viscosity correlated positively with age. There were significantly lower levels of haemorheological and clotting profile in post-menopausal women. These changes may be due to age or a decline in circulating oestrogen levels.

AIM: To investigate the effect of puerarin combined with lecithin complex iodine tablets on hemostasis in patients with fundus hemorrhage. METHODS: Totally 66 patients with fundus hemorrhage who entered into our hospital from April 2016 to March 2017 were collected and randomly divided into 2 groups: group A and group B, 33 cases(50 eyes)in each group. Group A was treated with lecithin complex iodine tablets, and group B was treated with puerarin combined with lecithin complex iodine tablets. Plasma viscosity index, serum homocysteine(Hcy), total cholesterol(TC)and triglyceride(TG)were measured and compared within 2 groups. The therapeutic effects and adverse reactions were compared between 2 groups. RESULTS: Before treatment, there were no significant differences in plasma viscosity, serum Hcy, TC and TG between 2 groups(P>0.05). After treatment, the high blood viscosity, low blood viscosity, low plasma viscosity, plasma viscosity, Hcy, TC and TG in 2 groups had decreased than before treatment(PPPP>0.05).CONCLUSION: The efficacy of puerarin combined with lecithin complex iodine tablets in the treatment of fundus hemorrhage is significant, which is related to improving plasma viscosity and decreasing serum Hcy, TC and TG.

Background. Yield shear stress (YSS) well characterizes the thixotropic status of blood, that exemplifies a reversible loss of blood fluidity due to a low shear rate. At the stable haematocrit ratio YSS depends mainly on the fibrinogen level. Aim. Since the role of other biochemical factors in the YSS phenomenon in cerebral ischaemia has not been well known, we have undertaken this problem in a group of stroke patients. Material and Methods. The study was carried out in 36 patients with acute ischaemic stroke and in 12 controls. YSS was estimated by means of microviscometric method. In all subjects the concentration of the following biochemical factors were assayed: albumin, IgG, IgA, IgM, apolipoprotein A, and B, cholesterol, triglycerides, LDL, HDL and fibrinogen. Then the thixotroipic effect of all biochemical factors and their correlations to fibrinogen were estimated by means of mathematical formulas. Results. We found a positive correlation in relation to the following thixotropic effects: for all subjects and separately for patients’ group: Alb(YSS) (p

AimThe aim of the present study was to investigate levels of some biochemical and whole blood count parameters and plasma viscosity in women with gestational diabetes mellitus (GDM) compared to healthy pregnant and healthy, non-pregnant women, and to evaluate the relationships between plasma viscosity.Material-MethodsThe patients consisted of 27 pregnant with GDM. The control groups consisted of 25 healthy pregnant and 24 healthy non-pregnant women. Blood glucose, insulin, glycosylated hemoglobin (HbA1c), total cholesterol, triacylglycerol, LDL-cholesterol, HDL-cholesterol, total protein, albumin, HbA1c, Hct, Hb, PLT, MPV were measured by auto-analyzer. Also, plasma viscosity levels were measured by capillary viscometer.ResultsThe levels of total protein, albumin, blood glucose, insulin, HOMAIR, HBA1c, total cholesterol, LDL-Cholesterol, HDL-Cholesterol and plazma viscosity in women with GDM group were found higher than those in healthy pregnant and non-pregnant women groups. In addition, the levels of triacylglycerol were significantly higher in GDM pregnants than those in the healthy pregnant women. There were significant positive correlations between plasma viscosity and total cholesterol levels of GDM patients. Additionally, there were significant positive correlations between plasma viscosity and LDL-cholesterol levels.ConclusionPlasma viscosity may contribute to useful information in early diagnosis and treatment, prevention of progression in GDM patients. It should be considered as an important parameter in clinical terms to ensure healthy fetal development.

Background: Endothelial nitric oxide synthase (eNOS) is generally expressed in endocardial cells, vascular endothelial cells and ventricular myocytes. However, there is no experimental study elucidating the relationship between cardiac eNOS expression and elevated plasma viscosity in low oxygen delivery pathological conditions such as hemorrhagic shock-resuscitation and hemodilution. This study tested the hypothesis that elevated plasma viscosity increases cardiac eNOS expression in a hemodilution model, leading to positive effects on cardiac performance. Materials and Methods: Two groups of golden Syrian hamster underwent an acute isovolemic hemodilution where 40% of blood volume was exchanged with 2% (low-viscogenic plasma expander [LVPE]) or 6% (high-viscogenic plasma expander [HVPE]) of dextran 2000 kDa. In control group, experiment was performed without hemodilution. All groups were performed in awake condition. Experimental parameters, i.e., mean arterial blood pressure (MAP), heart rate, hematocrit, blood gas content and viscosity, were measured. The eNOS expression was evaluated by eNOS Western blot analysis. Results: After hemodilution, MAP decreased to 72% and 93% of baseline in the LVPE and HVPE, respectively. Furthermore, pO 2 in the LVPE group increased highest among the groups. Plasma viscosity in the HVPE group was significantly higher than that in control and LVPE groups. The expression of eNOS in the HVPE group showed higher intensity compared to other groups, especially compared with the control group. Conclusion: Our results demonstrated that cardiac eNOS has responded to plasma viscosity modulation with HVPE and LVPE. This particularly supports the previous studies that revealed the positive effects on cardiac function in animals hemodiluted with HVPE.

OBJECTIVE: The accompanying thrombocytosis is referred to as the major factor associated with thromboembolism in iron deficiency anemia (IDA). Increased viscosity may increase the risk of thrombosis. We hypothesized that increased platelet count -with reactive thrombocytosis- might also affect plasma viscosity. We planned to evaluate the influence of normal and high platelet count on plasma viscosity in IDA patients. METHODS: The patient population consisted of fifty-three newly diagnosed and untreated women aged between 18 and 62 years with IDA. Group 1 consisted of 33 patients, platelet levels below 400 x 109/L. Group 2 consisted of 20 patients, platelet levels above 400 x 109/L. Measurements of plasma viscosity were performed using Brookfield viscometer. RESULTS: Mean plasma viscosity was found as 1.05 +- 0.08 mPa.s. in Group 1, and 1.03 +- 0.06 mPa.s. in Group 2. Mean plasma viscosity was not statistically different. White blood cell count was significantly higher in Group 2. Vitamin B12 levels were significantly higher in Group 2, while folic acid levels were higher in Group 1 (p=0.011 and p=0.033). Plasma viscosity was correlated with erythrocyte sedimentation rate (r=0.512 p=0.002) in Group 1 and inversely correlated with vitamin B12 (r=−0.480 p=0.032) in Group 2. CONCLUSION: Despite the significant difference between groups in terms of platelet count, no significant difference was detected in plasma viscosity and this finding could be explained as the following; 1-These platelets were not thrombocythemic platelets; 2-Similar to the theory about leukocytes, higher platelet counts – even non-thrombocythemic – may increase plasma viscosity; 3-Evaluating platelet count alone is not sufficient and the associating red-cell deformability should also be taken into account; and 4-Although other diseases that could affect viscosity are excluded, some definitely proven literature criteria such as fibrinogen, hyperlipidemia, and the inflammatory process should also be evaluated by laboratory and clinical measures.

Background : Previous studies have found that increasing plasma viscosity as whole blood viscosity decrease has beneficial effects in microvascular hemodynamics. As the heart couples with systemic vascular network, changes in plasma and blood viscosity during hemodilution determine vascular pressure drop and flow rate, which influence cardiac function. This study aimed to investigate how changes in plasma viscosity affect on cardiac function during acute isovolemic hemodilution. Materials and Methods: Plasma viscosity was modulated by hemodilution of 40% of blood volume with three different plasma expanders (PEs). Dextran 2000 kDa (Dx2M, 6.3 cP) and dextran 70 kDa (Dx70, 3.0 cP) were used as high and moderate viscogenic PEs, respectively. Polyethylene glycol conjugated with human serum albumin (PEG-HSA, 2.2 cP) was used as low viscogenic PE. The cardiac function was assessed using a miniaturized pressure-volume conductance catheter. Results: After hemodilution, pressure dropped to 84%, 79%, and 78% of baseline for Dx2M, Dx70 and PEG-HSA, respectively. Cardiac output markedly increased for Dx2M and PEG-HSA. Dx2M significantly produced higher stroke work relative to baseline and compared to Dx70. Conclusion: Acute hemodilution with PEG-HSA without increasing plasma viscosity provided beneficial effects on cardiac function compared to Dx70, and similar to those measured with Dx2M. Potentially negative effects of increasing peripheral vascular resistance due to the increase in plasma viscosity were prevented.

Background: We aimed to compare the effect of albumin 5% in half normal saline (half NS) versus normal saline (NS) infusion on the plasma viscosity in the near-normal physiological condition. According to the high oncotic pressure of albumin along with prolonged half-life of its molecules in comparison to NS in the intra-vascular compartment, it has been proposed that a more significant reduction of the plasma viscosity might be expected after the infusion of albumin. Methods: A total of 56 patients referring to the general operating room for their elective minor surgeries were evenly divided into two groups (V1, V2). It was calculated that 28 patients were needed to be enroll in each study group to detect a difference as big as 0.15 millipoise (mPa.s) with a statistical power of 80%. The V1 group received 1000 ml of NS but the V2 group received 1000 ml of recombinant albumin 5% in half NS within one hour, as fluid replacement therapy, during the intra-operative period. We have designed a simple measurement system according to Poiseuille’s formula by which the viscosity value could be measured reliably since the system was calibrated frequently using distilled water as a reference. Results: The mean value of the pre-operative plasma viscosity of the patients was 1. 73 ± 0.25 mPa.s and 1.76 ± 0.21 mPa.s in V1 and V2 groups respectively. After the infusion of the fluids, the mean viscosity values decreased to 1. 68 ± 0.30 mPa.s and 1.66 ± 0.17mPa.s in V1 and V2 groups respectively (p= 0.37).

Abstract Introduction Many studies suggest that elevated triglyceride levels are associated with increased long-term risk of stroke, including transient ischemic attacks. In addition, elevated triglyceride levels independently contribute to plasma viscosity and decreased blood flow. However, no consensus has been reached regarding the significance of hypertriglyceridemia as an independent risk factor for ischemic stroke. Case presentation We report the case of a patient admitted to our hospital for sudden onset of coma. Laboratory test results revealed he had high blood glucose (28.2mmol/L), high glycated hemoglobin (11.4 percent), considerably high serum triglyceride levels (171.5mmol/L; type V hyperlipoproteinemia), and high plasma viscosity (1.90mPa/s) with normal β-hydroxybutyric acid levels. His triglyceride levels decreased after administering intravenous fluids. Our patient’s consciousness level improved gradually over three days. All serum lipid levels decreased seven days after admission. Conclusions The findings in our patient’s case are likely explained by triglyceride-mediated hyperviscosity causing a transient ischemic attack. In the present report we suggest that when several tests do not reveal the cause of stroke-like symptoms, measurement of plasma viscosity may be informative.