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SCIENCE CHINA Life Sciences, https://doi.org/10.1007/s11427-020-1848-8

A botanical medicine dragon’s blood exhibited clinical antithrombosis efficacy similar to low molecular weight heparin

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  • ReceivedOct 5, 2020
  • AcceptedNov 9, 2020
  • PublishedJan 29, 2021

Abstract


Funded by

the National Natural Science Foundation of China(81788101)

the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(2017-I2M-1-009)


Acknowledgment

This work was supported by the National Natural Science Foundation of China (81788101) and the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (2017-I2M-1-009).


Interest statement

The author(s) declare that they have no conflict of interest.


Supplement

SUPPORTING INFORMATION

The supporting information is available online at 10.1007/s11427-020-1848-8. The supporting materials are published as submitted, without typesetting or editing. The responsibility for scientific accuracy and content remains entirely with the authors.


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  • Figure 1

    Patient selection and study design timeline. A, A cohort of 141 patients with lower limb fracture were recruited from the Department of Orthopaedic Trauma of Aviation General Hospital. Patients who were using other clinical drugs concurrently were excluded. Older patients or those in more serious condition were also excluded. The included patients were randomly divided into dragon’s blood and LMWH treatment groups. We finally focused on patients with hip fracture. B, Patients were examined successively for various indicators. Anticoagulant therapy began on the day following hospitalization day, continued until 24 hours before surgery, restarted on the day following surgery, and discontinued after 3 days. Then we performed the Doppler ultrasound and blood collection again.

  • Figure 2

    Clinical data in LMWH and dragon’s blood groups. A, RAPT score calculated before preoperative anticoagulation treatment. B, Thrombosis incidence calculated after postoperative anticoagulation treatment; six and two patients developed thrombi in the LMWH group and dragon’s blood group, respectively. C, Blood coagulation function indexes measured before preoperative and after postoperative anticoagulation treatment. *P<0.05, **P<0.01, ***P<0.001.

  • Figure 3

    Functional processes and blood coagulation-related genes influenced by LMWH and dragon’s blood treatment. A and B, GO term (biological process) enrichment of DEGs associated with LMWH treatment (A) and dragon’s blood treatment (B). Enrichment was visualized using the Enrichment Map application in Cytoscape. Biological processes are presented as nodes; the node color indicates the significance of the biological processes, and the node size reflects the object count enriched in the biological processes. The connection between biological processes is based on shared objects. C and D, Heat maps of DEGs that were enriched in the “blood coagulation” biological process in the LMWH (C) and dragon’s blood (D) groups. DEGs in each group were ranked by log2fold-change and the color gradation indicates the normalized gene read count.

  • Figure 4

    Pathway enrichment of DEGs associated with LMWH and dragon’s blood treatment. Pathways with FDR values less than 0.05 are shown in the LWMH group (A) and dragon’s blood group (B). The warm colors represent genes with significantly elevated expression after surgery, and the cool colors represent genes with significantly decreased expression after surgery. Rank indicates the pathway rank sorted by FDR. Detailed information about the enriched pathways and related genes is provided in Tables S5 and S6 in Supporting Information.

  • Figure 5

    Pearson correlation analysis between DEGs and clinical indexes. A, Heat map of the Pearson correlation coefficient. The warm colors represent significant positive correlations, and the cold colors represent significant negative correlations. White indicates no significant association. Detailed information about the enriched pathways and objects is provided in Tables S7 and S8 in Supporting Information. B, Genes that are strongly related to FIB and D-D in articles published in coagulation and other blood disease relevant fields (|R|≥0.8 and P<0.05). R1 indicates the PCC calculated in LMWH group, while R2 indicates the PCC in dragon’s blood group.

  • Table 1   Baseline characteristics analysisa)

    All patients(N=40)

    LMWH group(n=26)

    Dragon’s blood group (n=14)

    Test statistics

    P values

    Age, years

    70.20±2.789

    73.04±3.146

    64.93±5.294

    U=129.500

    0.136

    Gender, male/female

    17/23

    10/16

    7/7

    χ2(1)=0.496

    0.481

    Current or prior smoker, n (%)

    6 (15.0)

    5 (19.2)

    1 (7.1)

    0.399

    Aspirin medication history, n (%)

    3 (7.5)

    3 (11.5)

    0 (0)

    0.539

    Blood transfusion, n (%)

    12 (30.0)

    7 (26.9)

    5 (35.7)

    0.72

    Comorbidities

     

    Hypertension, n (%)

    21 (52.5)

    16 (61.5)

    5 (35.7)

    0.186

    Hyperlipidaemia, n (%)

    3 (7.5)

    3 (11.5)

    0 (0)

    0.539

    Diabetes, n (%)

    15 (37.5)

    11 (42.3)

    4 (28.6)

    0.502

    Heart failure or respiratory failure, n (%)

    2 (5.0)

    1 (3.8)

    1 (7.1)

    1

    Varix of lower limb, n (%)

    2 (5.0)

    1 (3.8)

    1 (7.1)

    1

    Malignant tumor, n (%)

    2 (5.0)

    2 (7.7)

    0 (0)

    0.533

    Em dash indicates Fisher’s exact test used with no test statistics; LMWH, low molecular weight heparin.

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